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Impact of surgical timing on survival in patients with infective endocarditis: a time-dependent analysis

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Abstract

The purpose of this study was to evaluate the impact of surgical timing on survival in patients with left-sided infective endocarditis (IE). This was a retrospective study including 313 patients with left-sided IE between 2009 and 2017. Surgery was defined as urgent (US) or early (ES) if performed within 7 or 28 days, respectively. A multivariable Cox regression analysis including US and ES as time-dependent variables was performed to assess the impact on 1-year mortality. ES was associated with a better survival (aHR 0.349, 95% CI 0.135–0.902), as US (aHR 0.262, 95% CI 0.075–0.915). ES and US were associated with a better prognosis in patients with left-sided IE.

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Data availability

All data relevant to the study is detailed in the manuscript and supplemental material.

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Acknowledgments

Members of Ospedale San Raffaele Endocarditis Team:

Paolo Scarpellini, Barbara Castiglioni, Marco Ripa, Chiara Oltolini, Chiara Tassan Din, Monica Guffanti, and Giacomo Coppalini (Unit of Infectious and Tropical Diseases); Michele De Bonis, Alessandro Castiglioni, Mariachiara Calabrese, David Ferrara, Giuseppe Iaci, Elisabetta Lapenna, Simona Nascimbene, and Benedetto Del Forno (Unit of Cardiac Surgery); Eustachio Agricola, Francesco Ancona, Stefano Stella, and Cristina Capogrosso (Unit of Non-invasive Cardiology); Silvia Carletti, Renée Pasciuta, Paola Cichero, and Nicasio Mancini (Unit of Microbiology and Virology); Elena Busnardo and Ursola Pajoro (Unit of Nuclear Medicine); and Antonio Esposito and Anna Palmisano (Unit of Clinical and Experimental Radiology).

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Author notes

  1. Marco Ripa and Stefania Chiappetta contributed equally to this work.

Authors and Affiliations

  1. Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Marco Ripa, Stefania Chiappetta, Barbara Castiglioni, Chiara Oltolini, Chiara Tassan Din & Paolo Scarpellini

  2. Unit of Non-invasive Cardiology, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Eustachio Agricola & Giovanni La Canna

  3. Unit of Nuclear Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Elena Busnardo & Ursola Pajoro

  4. Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Silvia Carletti & Renée Pasciuta

  5. Unit of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Alessandro Castiglioni & Michele De Bonis

Authors
  1. Marco Ripa
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  2. Stefania Chiappetta
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  3. Barbara Castiglioni
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  13. Chiara Tassan Din
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  14. Paolo Scarpellini
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Consortia

on behalf of Ospedale San Raffaele Endocarditis Team

Contributions

MR, SC: Conceptualization, data curation, formal analysis, investigation, methodology, and writing (original draft)

BC, EA, EB, SC, AC, MDB, GLC, CO, UP, RP, and CTD: Supervision, validation, and writing (review and editing)

PS: Conceptualization, supervision, validation, and writing (review and editing)

Corresponding author

Correspondence to Paolo Scarpellini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The research was conducted in accordance with the Declaration of Helsinki and national and institutional standards. The study was approved by the local Ethics Committee (SIIE-2018, 32/INT/2018).

Consent to participate

Informed consent was waived as all data were used anonymously.

Consent for publication

Informed consent was waived as all data were used anonymously.

Code availability

Statistical analysis was performed using SPSS 20.0 (IBM SPSS, USA).

Additional information

This study was carried out as part of our routine work.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The members of the Ospedale San Raffaele Endocarditis Team are listed in the Acknowledgments section.

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Ripa, M., Chiappetta, S., Castiglioni, B. et al. Impact of surgical timing on survival in patients with infective endocarditis: a time-dependent analysis. Eur J Clin Microbiol Infect Dis 40, 1319–1324 (2021). https://doi.org/10.1007/s10096-020-04133-x

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  • DOI: https://doi.org/10.1007/s10096-020-04133-x

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