Left-sided infective endocarditis in patients with liver cirrhosis

J. Ruiz-Morales; R. Ivanova-Georgieva; N. Fernández-Hidalgo; E. García-Cabrera; Jose M. Miró; P. Muñoz; B. Almirante; A. Plata-Ciézar; V. González-Ramallo; J. Gálvez-Acebal; M. C. Fariñas; J. M. Bravo-Ferrer; M. A. Goenaga-Sánchez; C. Hidalgo-Tenorio; J. Goikoetxea-Agirre; A. de Alarcón-González; Fernando Fernández Sánchez; Marian Noureddine; Gabriel Rosas; Javier de la Torre Lima; Ane Josune Goikoetxea-Agirre; José Aramendi; Elena Bereciartua; María Victoria Boado; Marta Campaña Lázaro; Juan José Goiti; José Luis Hernández; José Ramón Iruretagoyena; Josu Irurzun Zuazabal; Leire López-Soria; Miguel Montejo; Pedro María Pérez; Regino Rodríguez; Roberto Voces; Josefa Ruiz Morales; Radka Ivanova Georgieva; M. Victoria García López; Manuel Márquez Solero; Isabel Rodríguez Bailón; Gemma Sanchez Espín; Juan Otero; Miguel Angel Goenaga Sánchez; Ana María Cuende; Eduardo Gaminde; Pedro Idígoras; José Antonio Iribarren; Alberto Izaguirre Yarza; Carlos Reviejo; Tomás Echeverría; Ana Fuertes; Rafael Carrasco; Vicente Climent; Patricio Llamas; Esperanza Merino; Joaquín Plazas; Sergio Reus; Jose María Bravo Ferrer; Nemesio álvarez; María del Mar Carmona; Laura Castelo; José Cuenca; Pedro Llinares; Enrique Miguez Rey; María Rodríguez Mayo; Dolores Sousa; M. Carmen Zúñiga; Francisco Javier Martínez-Marcos; J. M. Lomas Cabezas; M. del Mar Alonso; Beatriz Castro; Dácil García Marrero; M. del Carmen Durán; M. Antonia Miguel Gómez; Juan La Calzada; Ibrahim Nassar; Antonio Plata Ciézar; José M. Reguera Iglesias; Víctor Asensi álvarez; Carlos Costas; Jesús de la Hera; Jonnathan Fernández Suárez; José Manuel García Ruiz; Lisardo Iglesias Fraile; José López Menéndez; Pilar Mencia Bajo; Carlos Morales; Alfonso Moreno Torrico; Carmen Palomo; Begoña Paya Martínez; ángeles Rodríguez; Raquel Rodríguez García; Mauricio Telenti; Manuel Almela; Yolanda Armero; Manuel Azqueta; Ximena Castañeda; Carlos Cervera; Carlos Falces; Cristina García-de-la-Maria; José M. Gatell

doi:10.1016/j.jinf.2015.09.005

Left-sided infective endocarditis in patients with liver cirrhosis

J. Ruiz-Morales, R. Ivanova-Georgieva, N. Fernández-Hidalgo, E. García-Cabrera, Jose M. Miró, P. Muñoz, B. Almirante, A. Plata-Ciézar, V. González-Ramallo, J. Gálvez-Acebal, M. C. Fariñas, J. M. Bravo-Ferrer, M. A. Goenaga-Sánchez, C. Hidalgo-Tenorio, J. Goikoetxea-Agirre, A. de Alarcón-González, Fernando Fernández Sánchez, Marian Noureddine, Gabriel Rosas, Javier de la Torre LimaAne Josune Goikoetxea-Agirre, José Aramendi, Elena Bereciartua, María Victoria Boado, Marta Campaña Lázaro, Juan José Goiti, José Luis Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, Josefa Ruiz Morales, Radka Ivanova Georgieva, M. Victoria García López, Manuel Márquez Solero, Isabel Rodríguez Bailón, Gemma Sanchez Espín, Juan Otero, Miguel Angel Goenaga Sánchez, Ana María Cuende, Eduardo Gaminde, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Tomás Echeverría, Ana Fuertes, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Jose María Bravo Ferrer, Nemesio álvarez, María del Mar Carmona, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Dolores Sousa, M. Carmen Zúñiga, Francisco Javier Martínez-Marcos, J. M. Lomas Cabezas, M. del Mar Alonso, Beatriz Castro, Dácil García Marrero, M. del Carmen Durán, M. Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, Antonio Plata Ciézar, José M. Reguera Iglesias, Víctor Asensi álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, José Manuel García Ruiz, Lisardo Iglesias Fraile, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, ángeles Rodríguez, Raquel Rodríguez García, Mauricio Telenti, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina García-de-la-Maria, José M. Gatell

Departament de Medicina

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© 2015 The British Infection Association. Objective: To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. Methods: Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. Results: A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23-1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery. Conclusions: Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.

Idioma original	Anglès
Pàgines (de-a)	627-641
Revista	Journal of Infection
Volum	71
Número	6
DOIs	https://doi.org/10.1016/j.jinf.2015.09.005
Estat de la publicació	Publicada - 1 de gen. 2015

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10.1016/j.jinf.2015.09.005

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https://www.scopus.com/pages/publications/84947609901

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Ruiz-Morales, J., Ivanova-Georgieva, R., Fernández-Hidalgo, N., García-Cabrera, E., Miró, J. M., Muñoz, P., Almirante, B., Plata-Ciézar, A., González-Ramallo, V., Gálvez-Acebal, J., Fariñas, M. C., Bravo-Ferrer, J. M., Goenaga-Sánchez, M. A., Hidalgo-Tenorio, C., Goikoetxea-Agirre, J., de Alarcón-González, A., Sánchez, F. F., Noureddine, M., Rosas, G., ... Gatell, J. M. (2015). Left-sided infective endocarditis in patients with liver cirrhosis. Journal of Infection, 71(6), 627-641. https://doi.org/10.1016/j.jinf.2015.09.005

@article{c15983eeb4f549d4a9f036c0439a72be,

title = "Left-sided infective endocarditis in patients with liver cirrhosis",

abstract = "{\textcopyright} 2015 The British Infection Association. Objective: To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. Methods: Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. Results: A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5\% vs. 28.4\%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95\% CI: 1.23-1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8\% vs. 28.4\% p = NS) and in this stage heart surgery had a protective effect (28\% in operated patients vs. 60\% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4\%) and C (52.9\%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50\%) compared to those where surgery was delayed (58\%) or not performed (74\%). Only one patient in stage C underwent surgery. Conclusions: Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.",

keywords = "Left-sided infectious endocarditis, Liver cirrhosis, Prognostic, Risk stratification, Surgery",

author = "J. Ruiz-Morales and R. Ivanova-Georgieva and N. Fern{\'a}ndez-Hidalgo and E. Garc{\'i}a-Cabrera and Mir{\'o}, \{Jose M.\} and P. Mu{\~n}oz and B. Almirante and A. Plata-Ci{\'e}zar and V. Gonz{\'a}lez-Ramallo and J. G{\'a}lvez-Acebal and Fari{\~n}as, \{M. C.\} and Bravo-Ferrer, \{J. M.\} and Goenaga-S{\'a}nchez, \{M. A.\} and C. Hidalgo-Tenorio and J. Goikoetxea-Agirre and \{de Alarc{\'o}n-Gonz{\'a}lez\}, A. and S{\'a}nchez, \{Fernando Fern{\'a}ndez\} and Marian Noureddine and Gabriel Rosas and \{de la Torre Lima\}, Javier and Goikoetxea-Agirre, \{Ane Josune\} and Jos{\'e} Aramendi and Elena Bereciartua and Boado, \{Mar{\'i}a Victoria\} and L{\'a}zaro, \{Marta Campa{\~n}a\} and Goiti, \{Juan Jos{\'e}\} and Hern{\'a}ndez, \{Jos{\'e} Luis\} and Iruretagoyena, \{Jos{\'e} Ram{\'o}n\} and Zuazabal, \{Josu Irurzun\} and Leire L{\'o}pez-Soria and Miguel Montejo and P{\'e}rez, \{Pedro Mar{\'i}a\} and Regino Rodr{\'i}guez and Roberto Voces and Morales, \{Josefa Ruiz\} and Georgieva, \{Radka Ivanova\} and \{Garc{\'i}a L{\'o}pez\}, \{M. Victoria\} and Solero, \{Manuel M{\'a}rquez\} and Bail{\'o}n, \{Isabel Rodr{\'i}guez\} and Esp{\'i}n, \{Gemma Sanchez\} and Juan Otero and S{\'a}nchez, \{Miguel Angel Goenaga\} and Cuende, \{Ana Mar{\'i}a\} and Eduardo Gaminde and Pedro Id{\'i}goras and Iribarren, \{Jos{\'e} Antonio\} and Yarza, \{Alberto Izaguirre\} and Carlos Reviejo and Tom{\'a}s Echeverr{\'i}a and Ana Fuertes and Rafael Carrasco and Vicente Climent and Patricio Llamas and Esperanza Merino and Joaqu{\'i}n Plazas and Sergio Reus and Ferrer, \{Jose Mar{\'i}a Bravo\} and Nemesio {\'a}lvarez and \{del Mar Carmona\}, Mar{\'i}a and Laura Castelo and Jos{\'e} Cuenca and Pedro Llinares and Rey, \{Enrique Miguez\} and Mayo, \{Mar{\'i}a Rodr{\'i}guez\} and Dolores Sousa and Z{\'u}{\~n}iga, \{M. Carmen\} and Mart{\'i}nez-Marcos, \{Francisco Javier\} and \{Lomas Cabezas\}, \{J. M.\} and \{del Mar Alonso\}, M. and Beatriz Castro and Marrero, \{D{\'a}cil Garc{\'i}a\} and \{del Carmen Dur{\'a}n\}, M. and \{Miguel G{\'o}mez\}, \{M. Antonia\} and \{La Calzada\}, Juan and Ibrahim Nassar and Ci{\'e}zar, \{Antonio Plata\} and \{Reguera Iglesias\}, \{Jos{\'e} M.\} and {\'a}lvarez, \{V{\'i}ctor Asensi\} and Carlos Costas and \{de la Hera\}, Jes{\'u}s and Su{\'a}rez, \{Jonnathan Fern{\'a}ndez\} and Ruiz, \{Jos{\'e} Manuel Garc{\'i}a\} and Fraile, \{Lisardo Iglesias\} and Men{\'e}ndez, \{Jos{\'e} L{\'o}pez\} and Bajo, \{Pilar Mencia\} and Carlos Morales and Torrico, \{Alfonso Moreno\} and Carmen Palomo and Mart{\'i}nez, \{Bego{\~n}a Paya\} and {\'a}ngeles Rodr{\'i}guez and Garc{\'i}a, \{Raquel Rodr{\'i}guez\} and Mauricio Telenti and Manuel Almela and Yolanda Armero and Manuel Azqueta and Ximena Casta{\~n}eda and Carlos Cervera and Carlos Falces and Cristina Garc{\'i}a-de-la-Maria and Gatell, \{Jos{\'e} M.\}",

year = "2015",

month = jan,

day = "1",

doi = "10.1016/j.jinf.2015.09.005",

language = "English",

volume = "71",

pages = "627--641",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders Ltd",

number = "6",

}

Ruiz-Morales, J, Ivanova-Georgieva, R, Fernández-Hidalgo, N, García-Cabrera, E, Miró, JM, Muñoz, P, Almirante, B, Plata-Ciézar, A, González-Ramallo, V, Gálvez-Acebal, J, Fariñas, MC, Bravo-Ferrer, JM, Goenaga-Sánchez, MA, Hidalgo-Tenorio, C, Goikoetxea-Agirre, J, de Alarcón-González, A, Sánchez, FF, Noureddine, M, Rosas, G, de la Torre Lima, J, Goikoetxea-Agirre, AJ, Aramendi, J, Bereciartua, E, Boado, MV, Lázaro, MC, Goiti, JJ, Hernández, JL, Iruretagoyena, JR, Zuazabal, JI, López-Soria, L, Montejo, M, Pérez, PM, Rodríguez, R, Voces, R, Morales, JR, Georgieva, RI, García López, MV, Solero, MM, Bailón, IR, Espín, GS, Otero, J, Sánchez, MAG, Cuende, AM, Gaminde, E, Idígoras, P, Iribarren, JA, Yarza, AI, Reviejo, C, Echeverría, T, Fuertes, A, Carrasco, R, Climent, V, Llamas, P, Merino, E, Plazas, J, Reus, S, Ferrer, JMB, álvarez, N, del Mar Carmona, M, Castelo, L, Cuenca, J, Llinares, P, Rey, EM, Mayo, MR, Sousa, D, Zúñiga, MC, Martínez-Marcos, FJ, Lomas Cabezas, JM, del Mar Alonso, M, Castro, B, Marrero, DG, del Carmen Durán, M, Miguel Gómez, MA, La Calzada, J, Nassar, I, Ciézar, AP, Reguera Iglesias, JM, álvarez, VA, Costas, C, de la Hera, J, Suárez, JF, Ruiz, JMG, Fraile, LI, Menéndez, JL, Bajo, PM, Morales, C, Torrico, AM, Palomo, C, Martínez, BP, Rodríguez, Á, García, RR, Telenti, M, Almela, M, Armero, Y, Azqueta, M, Castañeda, X, Cervera, C, Falces, C, García-de-la-Maria, C & Gatell, JM 2015, 'Left-sided infective endocarditis in patients with liver cirrhosis', Journal of Infection, vol. 71, núm. 6, pàg. 627-641. https://doi.org/10.1016/j.jinf.2015.09.005

TY - JOUR

T1 - Left-sided infective endocarditis in patients with liver cirrhosis

AU - Ruiz-Morales, J.

AU - Ivanova-Georgieva, R.

AU - Fernández-Hidalgo, N.

AU - García-Cabrera, E.

AU - Miró, Jose M.

AU - Muñoz, P.

AU - Almirante, B.

AU - Plata-Ciézar, A.

AU - González-Ramallo, V.

AU - Gálvez-Acebal, J.

AU - Fariñas, M. C.

AU - Bravo-Ferrer, J. M.

AU - Goenaga-Sánchez, M. A.

AU - Hidalgo-Tenorio, C.

AU - Goikoetxea-Agirre, J.

AU - de Alarcón-González, A.

AU - Sánchez, Fernando Fernández

AU - Noureddine, Marian

AU - Rosas, Gabriel

AU - de la Torre Lima, Javier

AU - Goikoetxea-Agirre, Ane Josune

AU - Aramendi, José

AU - Bereciartua, Elena

AU - Boado, María Victoria

AU - Lázaro, Marta Campaña

AU - Goiti, Juan José

AU - Hernández, José Luis

AU - Iruretagoyena, José Ramón

AU - Zuazabal, Josu Irurzun

AU - López-Soria, Leire

AU - Montejo, Miguel

AU - Pérez, Pedro María

AU - Rodríguez, Regino

AU - Voces, Roberto

AU - Morales, Josefa Ruiz

AU - Georgieva, Radka Ivanova

AU - García López, M. Victoria

AU - Solero, Manuel Márquez

AU - Bailón, Isabel Rodríguez

AU - Espín, Gemma Sanchez

AU - Otero, Juan

AU - Sánchez, Miguel Angel Goenaga

AU - Cuende, Ana María

AU - Gaminde, Eduardo

AU - Idígoras, Pedro

AU - Iribarren, José Antonio

AU - Yarza, Alberto Izaguirre

AU - Reviejo, Carlos

AU - Echeverría, Tomás

AU - Fuertes, Ana

AU - Carrasco, Rafael

AU - Climent, Vicente

AU - Llamas, Patricio

AU - Merino, Esperanza

AU - Plazas, Joaquín

AU - Reus, Sergio

AU - Ferrer, Jose María Bravo

AU - álvarez, Nemesio

AU - del Mar Carmona, María

AU - Castelo, Laura

AU - Cuenca, José

AU - Llinares, Pedro

AU - Rey, Enrique Miguez

AU - Mayo, María Rodríguez

AU - Sousa, Dolores

AU - Zúñiga, M. Carmen

AU - Martínez-Marcos, Francisco Javier

AU - Lomas Cabezas, J. M.

AU - del Mar Alonso, M.

AU - Castro, Beatriz

AU - Marrero, Dácil García

AU - del Carmen Durán, M.

AU - Miguel Gómez, M. Antonia

AU - La Calzada, Juan

AU - Nassar, Ibrahim

AU - Ciézar, Antonio Plata

AU - Reguera Iglesias, José M.

AU - álvarez, Víctor Asensi

AU - Costas, Carlos

AU - de la Hera, Jesús

AU - Suárez, Jonnathan Fernández

AU - Ruiz, José Manuel García

AU - Fraile, Lisardo Iglesias

AU - Menéndez, José López

AU - Bajo, Pilar Mencia

AU - Morales, Carlos

AU - Torrico, Alfonso Moreno

AU - Palomo, Carmen

AU - Martínez, Begoña Paya

AU - Rodríguez, ángeles

AU - García, Raquel Rodríguez

AU - Telenti, Mauricio

AU - Almela, Manuel

AU - Armero, Yolanda

AU - Azqueta, Manuel

AU - Castañeda, Ximena

AU - Cervera, Carlos

AU - Falces, Carlos

AU - García-de-la-Maria, Cristina

AU - Gatell, José M.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - © 2015 The British Infection Association. Objective: To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. Methods: Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. Results: A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23-1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery. Conclusions: Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.

AB - © 2015 The British Infection Association. Objective: To evaluate the course of left-sided infective endocarditis (LsIE) in patients with liver cirrhosis (LC) analyzing its influence on mortality and the impact of surgery. Methods: Prospective cohort study, conducted from 1984 to 2013 in 26 Spanish hospitals. Results: A total of 3.136 patients with LsIE were enrolled and 308 had LC: 151 Child-Pugh A, 103 B, 34 C and 20 were excluded because of unknown stage. Mortality was significantly higher in the patients with LsIE and LC (42.5% vs. 28.4%; p < 0.01) and this condition was in general an independent worse factor for outcome (HR 1.51, 95% CI: 1.23-1.85; p < 0.001). However, patients in stage A had similar mortality to patients without cirrhosis (31.8% vs. 28.4% p = NS) and in this stage heart surgery had a protective effect (28% in operated patients vs. 60% in non-operated when it was indicated). Mortality was significantly higher in stages B (52.4%) and C (52.9%) and the prognosis was better for patients in stage B who underwent surgery immediately (mortality 50%) compared to those where surgery was delayed (58%) or not performed (74%). Only one patient in stage C underwent surgery. Conclusions: Patients with liver cirrhosis and infective endocarditis have a poorer prognosis only in stages B and C. Early surgery must be performed in stages A and although in selected patients in stage B when indicated.

KW - Left-sided infectious endocarditis

KW - Liver cirrhosis

KW - Prognostic

KW - Risk stratification

KW - Surgery

UR - https://www.scopus.com/pages/publications/84947609901

U2 - 10.1016/j.jinf.2015.09.005

DO - 10.1016/j.jinf.2015.09.005

M3 - Article

SN - 0163-4453

VL - 71

SP - 627

EP - 641

JO - Journal of Infection

JF - Journal of Infection

IS - 6

ER -

Left-sided infective endocarditis in patients with liver cirrhosis

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