Minimally Invasive Aortic Valve Surgery in the Elderly: A Case-Control Study

Aim: This study examined the role of lymphocyte-to-monocyte ratio (LMR), an inflammatory biomarker, in predicting the severity of calcific aortic valve stenosis (CAVS) in a Chinese case–control study. Results: The LMR significantly decreased in the patients with CAVS compared with healthy controls. An inverse correlation was observed between the severity of stenosis and LMR in the patients. Additionally, the LMR was identified in the multivariate analysis as an independent predictor of severe CAVS. Conclusion: This study provides evidence of an inverse correlation between the severity of CAVS and LMR. LMR could potentially be applied as an independent predictor of severe CAVS and could be incorporated into a novel predictive model.

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705. Factors Associated with Local Invasion in Infective Endocarditis: a Nested Case-control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.897 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S403-S403

Author(s):

Abarna Ramanathan ◽

James Witten ◽

Steven M Gordon ◽

Brian Griffin ◽

Gosta Pettersson ◽

...

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Case Control Study ◽

Cleveland Clinic ◽

Case Control ◽

Paravalvular Leak ◽

Multivariable Logistic Regression Model ◽

Local Invasion ◽

Nested Case Control ◽

Control Study

Abstract Background A substantial proportion of infective endocarditis (IE) cases are complicated by local invasion. The purpose of this study was to identify patient and disease characteristics that increase the odds of local invasion in surgically treated IE patients. Methods This was a nested case-control study. All episodes of IE for patients admitted to Cleveland Clinic from January 1st, 2013 – June 30th, 2016 were identified from the Cleveland Clinic IE Registry. Patients >18 years of age who underwent surgery for IE were included. Data was compiled by manual review of the Electronic Medical Record. Local invasion, defined as peri-annular extension, peri-valvular abscess, intra-cardiac fistula or pseudoaneurysm, was ascertained from the surgical operative note. Associations of selected factors with local invasion were examined in a multivariable logistic regression model. Results Among 510 patients who met inclusion criteria, 206 had local invasion. Mean age was 56 years and 369 (72 %) were male. Overall 344 (67 %) had aortic valve, 228 (45%) mitral valve, and 66 (13%) tricuspid or pulmonic valve involvement. Aortic valve involvement (OR 5.76, 95% CI 3.44 – 9.98), mechanical valve (OR 7.63, 95% CI 3.63 – 17.07), bioprosthetic valve (OR 3.20, 95% CI 1.99 – 5.19), significant paravalvular leak (OR 2.27, 95% CI 1.09 – 4.97), new atrioventricular nodal block (OR 3.05, 95% CI 1.57 – 6.09), Staphylococcus aureus infection (OR 2.11, 95% CI 1.20 – 3.76), coagulase negative staphylococcal infection (OR 2.38, 95% CI1.27 – 4.54), and non- viridans group streptococcal infection (OR 4.21, 95% CI 1.81 – 10.06) were significantly associated with local invasion. Conclusion Intra-cardiac and microorganism factors, but not comorbid conditions, are associated with local invasion in IE. Disclosures All Authors: No reported disclosures

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744. Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine and Influenza Vaccine Against Pneumococcal Pneumonia Among Elderly Patients Aged 65 Years and Older in the Republic of Korea: A Case–Control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.751 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S267-S267

Author(s):

Jong Hun Kim ◽

Byung Chul Chun ◽

Joon Young Song ◽

Hyo Youl Kim ◽

In-Gyu Bae ◽

...

Keyword(s):

Elderly Patients ◽

Elderly Population ◽

Case Control Study ◽

The Elderly ◽

Case Control ◽

Polysaccharide Vaccine ◽

Vaccine Effectiveness ◽

Pneumococcal Polysaccharide Vaccine ◽

The Republic ◽

Control Study

Abstract Background The national immunization program (NIP) of annual influenza vaccination to the elderly population (≥65 years of age) in the Republic of Korea (ROK) has been implemented since 1987. Recently, the 23-valent pneumococcal polysaccharide vaccine (PPV23) through the NIP has been provided to the elderly population in the ROK since May 2013. The aim of this study was to assess PPV23 and influenza vaccine (IV) effectiveness in preventing pneumococcal pneumonia (PP) among elderly patients ≥65 years of age. Methods A case–control study using a hospital-based cohort was conducted. Cases of PP including bacteremic PP and nonbacteremic PP were collected from 14 hospitals in the pneumococcal diseases surveillance program from March 2013 to October 2015. Controls matched by age and sex in the same hospital were selected. Demographic, clinical information, and vaccination histories were collected. Previous immunization was categorized into “vaccinated” if a patient had received vaccines as follows: PPV23 (4 weeks to 5 years) and IV (2 weeks to 6 months) prior to the diagnosis of PP for case patients and prior to the hospital admission for control patients. Adjusted odds ratio (OR) was calculated, controlling for underlying medical conditions. Vaccine effectiveness was defined as (1 – OR) × 100. Results During the study period, a total of 661 cases (104 bacteremic PP cases and 557 nonbacteremic PP cases) and 661 controls were enrolled for analyses. For overall patients ≥65 years of age, there was no significant vaccine effectiveness against PP. For young elderly patients with 65–74 years, IV alone (1.2%, [95% confidence interval (CI) −95.3% to 50.0%]) and PPV23 alone (21.9%, [95% CI −39.0% to 56.1%]) were not effective. However, significant vaccine effectiveness of PPV23 plus IV against PP was noted (54.4%, [95% CI 6.9–77.7%], P = 0.031). For older elderly patients ≥75 years of age, no significant vaccine effectiveness was observed. Conclusion Our study indicates that PPV23 plus IV may be effective in preventing PP among young elderly patients with 65–74 years, suggesting additive benefits of influenza plus PPV23 vaccination. Further studies are required to confirm the persistent additive protective effectiveness. Disclosures All authors: No reported disclosures.

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Preliminary Results of Robotic Lobectomy in Stage IIIA-N2 NSCLC after Induction Treatment: A Case Control Study

Journal of Clinical Medicine ◽

10.3390/jcm10163465 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3465

Author(s):

Monica Casiraghi ◽

Francesco Petrella ◽

Giulia Sedda ◽

Antonio Mazzella ◽

Juliana Guarize ◽

...

Keyword(s):

Lymph Node ◽

Minimally Invasive ◽

Open Surgery ◽

Case Control Study ◽

Locally Advanced ◽

Case Control ◽

Induction Treatment ◽

Stage Iiia ◽

Robot Assisted ◽

Control Study

Despite there already being many studies on robotic surgery as a minimally invasive approach for non-small-cell lung cancer (NSCLC) patients, the use of this technique for stage III disease is still poorly described. These are the preliminary results of our prospective study on the safety and effectiveness of robotic approaches in patients with locally advanced NSCLC in terms of postoperative complications and oncological outcomes. Since 2016, we prospectively investigated 19 consecutive patients with NSCLC stage IIIA-pN2 (diagnosed by EBUS-TBNA) who underwent lobectomy and radical lymph node dissection with robotic approaches after induction treatment. Furthermore, we matched a case-control study with 46 patients treated with open surgery during the same period of time, with similar age, comorbidities, clinical stage and tumor size. The individual matched population was composed of 16 robot-assisted thoracic surgeries and 16 patients who underwent open surgery. The median time range of resection was inferior in the open group compared to robotic lobectomy (243 vs. 161 min; p < 0.001). Lymph node resection and positivity were not significantly different (p = 0.96 and p = 0.57, respectively). Moreover, no difference was observed for PFS (p = 0.16) or OS (p = 0.41). In conclusion, we demonstrated that the early outcomes and oncological results of N2-patients after robotic lobectomy were similar to those who had open surgery. Considering the advantages of minimally invasive surgery, robot-assisted lobectomy appears to be a safe approach to patients with locally advanced diseases.

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