title: Long-term prognosis of left-sided native-valve Staphylococcus aureus endocarditis.
abstract: BACKGROUND
  Staphylococcus aureus infective endocarditis (SAIE) is a serious and common disease.
  
  
  OBJECTIVE
  To assess the clinical and echocardiographic characteristics and prognostic factors of left-sided native-valve SAIE, and to compare these characteristics between two periods (1990-2000 vs. 2001-2010).
  
  
  METHODS
  This was a retrospective analysis of 162 cases of left-sided native-valve SAIE among 1254 patients hospitalized for infective endocarditis (IE) between 1990 and 2010.
  
  
  RESULTS
  SAIE represented 18.1% of all cases of IE and 22.9% of cases of native-valve IE. Complications included heart failure in 44.7% of cases, acute renal failure in 23.3%, sepsis in 28.5%, neurological events in 35.8%, systemic embolic events in 54.9% and in-hospital mortality in 25.3%. Factors associated with in-hospital mortality were heart failure (odds ratio [OR] 2.5; P=0.04) and sepsis (OR 5.3; P=0.001). Long-term 5-year survival was 49.6±4.9%. Factors associated with long-term mortality were heart failure (OR 1.7; P=0.032), sepsis (OR 3; P=0.0001) and delayed surgery (OR 0.43; P=0.003). Comparison of the two periods revealed a significant increase in bivalvular involvement, valvular incompetence and acute renal failure from 2001 to 2010. No significant difference was observed in terms of in-hospital mortality rates (28.1% vs. 23.5%; P=0.58) and long-term 5-year survival (45.0±6.6% vs. 57.1±6.4%; P=0.33).
  
  
  CONCLUSIONS
  Mortality as a result of left-sided native-valve SAIE remains high. Factors associated with in-hospital mortality are heart failure and sepsis. Factors associated with long-term mortality are heart failure, sepsis and delayed surgery. Despite progress in surgical techniques, in-hospital mortality and long-term mortality have not decreased significantly between the two periods.
authors.affiliation: Département de cardiologie, centre hospitalier universitaire Amiens-Picardie, 80054 Amiens, France.
authors.forename: Layal
authors.initials: L
authors.lastname: Abdallah
authors.affiliation: Département de cardiologie, centre hospitalier universitaire Amiens-Picardie, 80054 Amiens, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Remadi
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, centre hospitalier universitaire de Marseille, 13385 Marseille, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, centre hospitalier universitaire de Marseille, 13385 Marseille, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Salaun
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, centre hospitalier universitaire de Marseille, 13385 Marseille, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Casalta
authors.affiliation: Département de cardiologie, centre hospitalier universitaire Amiens-Picardie, 80054 Amiens, France. Electronic address: tribouilloy.christophe@chu-amiens.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
mesh_terms: D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000401:mortality*; D013997:Time Factors
keywords: Endocardite infectieuse; Infective endocarditis; Left-sided native valve; Prognosis; Pronostic; Staphylococcus aureus; Valves natives gauches; Évolution