초록접수 현황
| 20F-045 | 구연 발표 |
Vegetation size, multiplicity, and position in patients with infective endocarditis: Focusing on cerebral embolism and long-term clinical outcomes
Seung Jun Song, MD, PhD¹; Hi Jae Lee, RN²; Sak Lee, MD, PhD²; Hyun-Cheol Joo, MD²; Young- Nam Youn, MD, PhD²; Kyung-Jong Yoo, MD, PhD²; Seung Hyun Lee, MD, PhD²
¹Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
²Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
Purpose : Infective endocarditis (IE) is a life-threating condition and is associated with embolic events. We aimed to evaluate the association of vegetation size, multiplicity, and position with cerebral embolism (CE) and long-term survival in patients with IE.
Methods : We retrospectively reviewed patients with IE who were admitted to a single institution between November 2005 and August 2017. A total of 419 patients with IE were included in the study, 273 of whom had undergone surgery. The primary endpoint was all-cause mortality, and the secondary endpoint was CE including various other embolic events. Multivariate Cox regression and logistic regression analyses were performed to identify independent risk factors for 30-day mortality, long-term mortality, and CE.
Results : Age [odds ratio (OR), 1.02; 95% confidence interval (CI), 1.00–1.04], surgery (OR, 0.31; 95% CI, 0.21–0.46), renal failure (OR, 4.21; 95% CI, 2.67–6.65), peripheral embolism (OR, 2.91; 95% CI, 1.64–5.17), and chronic Health Evaluation II (APACHE II) score (OR, 1.08; 95% CI, 1.01–1.15) were associated with long-term mortality. Vegetation multiplicity, position, and size were not significantly associated with long-term mortality. For CE, a mitral vegetation size of greater than 10 mm (OR, 2.25; 95% CI, 1.32–3.84) was an independent risk factor.
Conclusion : A vegetation size of at least 10 mm in the mitral position was found to be a significant risk factor for CE. Thus, in patients with a vegetation size of 10 mm or larger, especially in the MV, early surgery should be considered to prevent CE.
Methods : We retrospectively reviewed patients with IE who were admitted to a single institution between November 2005 and August 2017. A total of 419 patients with IE were included in the study, 273 of whom had undergone surgery. The primary endpoint was all-cause mortality, and the secondary endpoint was CE including various other embolic events. Multivariate Cox regression and logistic regression analyses were performed to identify independent risk factors for 30-day mortality, long-term mortality, and CE.
Results : Age [odds ratio (OR), 1.02; 95% confidence interval (CI), 1.00–1.04], surgery (OR, 0.31; 95% CI, 0.21–0.46), renal failure (OR, 4.21; 95% CI, 2.67–6.65), peripheral embolism (OR, 2.91; 95% CI, 1.64–5.17), and chronic Health Evaluation II (APACHE II) score (OR, 1.08; 95% CI, 1.01–1.15) were associated with long-term mortality. Vegetation multiplicity, position, and size were not significantly associated with long-term mortality. For CE, a mitral vegetation size of greater than 10 mm (OR, 2.25; 95% CI, 1.32–3.84) was an independent risk factor.
Conclusion : A vegetation size of at least 10 mm in the mitral position was found to be a significant risk factor for CE. Thus, in patients with a vegetation size of 10 mm or larger, especially in the MV, early surgery should be considered to prevent CE.
책임저자: Seung Hyun Lee
Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
발표자: Seung Jun Song, E-mail : songseungjun@yuhs.ac