International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
LATE ONSET PROSTHETIC VALVE ENDOCARDITIS: INSIGHTS INTO A PROSPECTIVE COHORT AND RISK FACTORS ASSOCIATED WITH MORTALITY.
СтатьяНазвание и аннотация: Перевод в очереди
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Pompeo Guilherme S, Siciliano Rinaldo Focaccia, Barbosa Giovanna Ianini Ferraiuoli, Garrido Rafael Quaresma, Zappa Bruno Cordeiro, de Amorim Guilherme Dalcol Torres, Golebiovski Wilma Félix, Feijóo Nicolas, Strabelli Tânia Mara Varejão, Tarasoutchi Flávio, von Doellinger Vanessa, Correia Marcelo Goulart, Lamas Cristiane C
Аннотация
OBJECTIVES: To evaluate episodes of late prosthetic valve infective endocarditis (LPVIE) and mortality associated risk factors.
METHODS: We conducted an observational study of LPVIE cases recorded between 2006 and 2023 at two Brazilian cardiac surgery centres. Adults with a definite diagnosis of LPVIE according to the modified Duke criteria were included.
RESULTS: A total of 394 episodes were analyzed; 63.2% affected males. The mean age was 54.8 ± 17.39 years. Fever occurred in 77.9%, embolization in 20.6%, vegetations in 49.1% and paravalvular abscesses (PA) in 20.6% of patients. Blood cultures were negative in 21.1%. Surgery was indicated in 68.5% and performed in 81.9%. In-hospital mortality was 31%. Risk factors for mortality were acute renal failure, OR 32.80 (95% CI 13.38-80.38; p < 0.0001); PA, OR 9.37 (CI 3.23-27.15; p < 0.0001); failure to undergo surgery when indicated, OR 6.58 (CI 1.88-23.06; p = 0.003); acute heart failure, OR 4.65 (CI 1.95-11.09; p = 0.0005); dehiscence, OR 4.05 (95% CI 1.15-14.21; p = 0.029); age ≥ 60 years, OR 1.05 (95% CI 1.02-1.09; p = 0.0004).
CONCLUSION: LPVIE was associated with high mortality and complications. Early identification of structural complications and timely surgical evaluation may improve prognosis.
METHODS: We conducted an observational study of LPVIE cases recorded between 2006 and 2023 at two Brazilian cardiac surgery centres. Adults with a definite diagnosis of LPVIE according to the modified Duke criteria were included.
RESULTS: A total of 394 episodes were analyzed; 63.2% affected males. The mean age was 54.8 ± 17.39 years. Fever occurred in 77.9%, embolization in 20.6%, vegetations in 49.1% and paravalvular abscesses (PA) in 20.6% of patients. Blood cultures were negative in 21.1%. Surgery was indicated in 68.5% and performed in 81.9%. In-hospital mortality was 31%. Risk factors for mortality were acute renal failure, OR 32.80 (95% CI 13.38-80.38; p < 0.0001); PA, OR 9.37 (CI 3.23-27.15; p < 0.0001); failure to undergo surgery when indicated, OR 6.58 (CI 1.88-23.06; p = 0.003); acute heart failure, OR 4.65 (CI 1.95-11.09; p = 0.0005); dehiscence, OR 4.05 (95% CI 1.15-14.21; p = 0.029); age ≥ 60 years, OR 1.05 (95% CI 1.02-1.09; p = 0.0004).
CONCLUSION: LPVIE was associated with high mortality and complications. Early identification of structural complications and timely surgical evaluation may improve prognosis.