Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319254
Author(s):  
Laura Varela Barca ◽  
Laura Vidal-Bonnet ◽  
MC Fariñas ◽  
Patricia Muñoz ◽  
Maricela Valerio Minero ◽  
...  
Keyword(s):  
Sex Differences ◽  
Infective Endocarditis ◽  
Risk Evaluation ◽  
Statistical Difference ◽  
Clinical Presentation ◽  
National Level ◽  
Presentation Modality ◽  
Female Sex ◽  
European System ◽  
Cardiac Operative Risk Evaluation

IntroductionSex-dependent differences of infective endocarditis (IE) have been reported. Women suffer from IE less frequently than men and tend to present more severe manifestations. Our objective was to analyse the sex-based differences of IE in the clinical presentation, treatment, and prognosis.Material and methodsWe analysed the sex differences in the clinical presentation, modality of treatment and prognosis of IE in a national-level multicentric cohort between 2008 and 2018. All data were prospectively recorded by the GAMES cohort (Spanish Collaboration on Endocarditis).ResultsA total of 3451 patients were included, of whom 1105 were women (32.0%). Women were older than men (mean age, 68.4 vs 64.5). The most frequently affected valves were the aortic valve in men (50.6%) and mitral valve in women (48.7%). Staphylococcus aureus aetiology was more frequent in women (30.1% vs 23.1%; p<0.001).Surgery was performed in 38.3% of women and 50% of men. After propensity score (PS) matching for age and estimated surgical risk (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II)), the analysis of the matched cohorts revealed that women were less likely to undergo surgery (OR 0.74; 95% CI 0.59 to 0.91; p=0.05).The observed overall in-hospital mortality was 32.8% in women and 25.7% in men (OR for the mortality of female sex 1.41; 95% CI 1.21 to 1.65; p<0.001). This statistical difference was not modified after adjusting for all possible confounders.ConclusionsFemale sex was an independent factor related to mortality after adjusting for confounders. In addition, women were less frequently referred for surgical treatment.

scholarly journals Locally derived system for cardiac operative risk evaluation

2014 ◽  
Vol 67 (11-12) ◽  
pp. 367-371
Author(s):  
Bogoljub Mihajlovic ◽  
Bojan Mihajlovic ◽  
Milica Panic ◽  
Milana Jarakovic ◽  
Snezana Bjelica ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Evaluation ◽  
Operative Risk ◽  
Local Model ◽  
Combined Surgery ◽  
European Model ◽  
Valvular Surgery ◽  
European System ◽  
Local Risk ◽  
Cardiac Operative Risk Evaluation

Introduction. During the last two decades, many authors have found that European Systems for Cardiac Operative Risk Evaluation (additive and logistic models) overestimate the risk in cardiac surgery. The new European model has recently been introduced as an update to previous versions. The aim of the study was to investigate the significance of locally derived system for cardiac operative risk evaluation and to compare its predictive power with the existing European systems. Material and Methods. For developing a local risk prediction model, data from 2681 patients submitted to cardiac surgery at the Institute of Cardiovascular Diseases Vojvodina have thoroughly been collected. Logistic regression analysis was used to construct a local model for prediction of outcome. The evaluation of the local model and three European systems was performed by comparing the observed and expected hospital mortality. Results. The difference between the predicted and observed mortality regardless of the type of surgery was statistically insignificant for the additive European system (p=0.073) and the local model (p=0.134). The logistic European system overestimated the operative risk, while the new European model underestimated mortality. In coronary surgery, all models, except the logistic European system, performed well. In valvular surgery, the new European model and the local model underestimated mortality significantly, while the additive and logistic European models performed well. In combined surgery, the new European system significantly underestimated mortality (p=0.029), while the local model performed well (p=0.252). Conclusion. The locally derived model shows satisfactory results, with good calibration and discriminative power. The local model specifically outperforms all other European systems in terms of discriminatory power in combined surgery subset.

scholarly journals Penilaian Praoperasi Bedah Jantung

2018 ◽  
Vol 10 (3) ◽  
pp. 175
Author(s):  
Donni Indra Kusuma ◽  
Heru Dwi Jatmiko
Keyword(s):  
Informed Consent ◽  
Risk Evaluation ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Operative Risk ◽  
Evaluation Score ◽  
Cardiac Anaesthesia ◽  
European System ◽  
Cardiac Operative Risk Evaluation

Meskipun perkembangan ilmu kedokteran mengenai patofisiologi penyakit kardiovaskular sudah berkembang, namun penyakit ini tetap menjadi penyebab kematian terbanyak di seluruh dunia. Bedah jantung menawarkan potensi yang cukup menguntungkan bagi sebagian besar pasien. Berbagai macam cara dilakukan untuk mengoptimalkan hasil dari bedah jantung dan menurunkan tingkat mortalitas pascaoperasi. Salah satu cara yang dapat dilakukan adalah penilaian praoperasi pasien sebelum melakukan bedah jantung. Penilaian praoperasi pasien yang akan dilakukan operasi jantung meliputi empat hal utama, yaitu anamnesis, pemeriksaan fisik, pemeriksaan laboratorium, dan pemeriksaan kardiologi.Penilaian risiko diperlukan oleh dokter anestesi untuk menilai faktor-faktor risiko yang dimiliki pasien dan bagaimana pengaruhnya dengan tingkat mortalitas pasien apabila dilakukan operasi jantung. Sistem penilaian yang sering digunakan antara lain indeks risiko jantung praoperasi dari Detsky, sistem penilaian European System for Cardiac Operative Risk Evaluation (EuroSCORE), dan Cardiac Anaesthesia Risk Evaluation Score (CARE). American College of Cardiology (ACC) dan American Heart Association (AHA) menyusun sebuah algoritme mengenai pendekatan dalam pemeriksaan jantung praoperasi. Algoritme ini membantu dokter dalam memberikan informed consent dan sebagai panduan dalam manajemen perioperatif untuk meminimalkan risiko.

scholarly journals European system for cardiac operative risk evaluation (EuroSCORE)

1999 ◽  
Vol 16 (1) ◽  
pp. 9-13 ◽  
Author(s):  
S.A.M. Nashef ◽  
F. Roques ◽  
P. Michel ◽  
E. Gauducheau ◽  
S. Lemeshow ◽  
...  
Keyword(s):  
Risk Evaluation ◽  
Operative Risk ◽  
European System ◽  
Cardiac Operative Risk Evaluation
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