engleski

Influence of itme of cardiac surgery (CS) on the outcome of patients with infective endocarditis (IE) and stroke

Background: The optimal time-to-CS after stroke in patients with IE is still controversial. The goal of this study was to quantify how such operative decisions influence patients' outcome. Methods: Data from the ICE-PCS Study Group were used. Inclusion criteria: definite IE complicated by stroke, CS performed after stroke, known dates of both stroke and CS. Results: 245 patients satisfied inclusion criteria. There were no differences regarding demographic and base-line characteristics. Stroke was characterized as embolic in 204 (83.3%), hemorrhagic in 20 (8, 2%), and not specified in 21 (8, 6%) patients. Hospital mortality was significantly higher if CS was performed within 14d of stroke event. There were no differences in the mortality at the one-year follow-up period among hospital survivors. The incidence of intracardiac abscess was more common in earlier CS groups. The incidence of other manifestations of complicated IE did not differ between groups. There were no differences in mortality in the follow-up period. Conclusions: The risk of in-hospital mortality is clearly higher if CS is performed within 14 days from stroke onset in IE. However, such hazards may be unavoidable if urgent CS is mandated by uncontrolled infections (e.g. intracardiac abscess).

infective endocarditis; stroke; cardiac surgery

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