계명대학교 의학도서관 Repository

Clinical significance of cerebrovascular complications in patients with acute infective endocarditis: a retrospective analysis of a 12-year single-center experience

Metadata Downloads
Author(s)
김재현나찬영
Alternative Author(s)
Kim, Jae HyunNa, Chan Young
Publication Year
2014
Abstract
BACKGROUND:
Cerebrovascular complications (CVCs) frequently occur in patients with acute infective endocarditis (IE). The aim of this study is to describe the clinical findings of CVCs and to evaluate the impact of CVCs on long-term mortality in patients with IE.

METHODS:
We retrospectively analyzed 144 patients who fulfilled the modified Duke's criteria for definite left-sided IE. CVCs were classified into minor (silent cerebral embolism, TIA and stroke with an initial modified Rankin scale ≤ 2) or major (an initial modified Rankin scale ≥ 3) CVCs. Cox proportional hazards model was used for mortality analysis. Hazard ratio (HR) and 95% confidence interval (CI) were obtained.

RESULTS:
The mean age of the 144 patients (96 males and 48 females) was 49.1 years (range 6-85 years). A CVC was found in 37 (25.7%) patients. Of these, 25 were treated with surgical therapy. The patients who underwent early surgery within 2 weeks after stroke had a statistical trend toward a higher risk of postoperative brain hemorrhage (50% versus 4.8%, P = 0.057 by Fisher exact test). The minor CVC group had a similar risk of death as the no-CVC group (P = 0.803; HR 0.856; CI 0.253-2.894), whereas the major CVC group had a higher mortality (P = 0.013; HR 2.865; CI 1.254-6.548) than the no-CVC group. In the multivariate analysis, major CVC (P = 0.002; HR 3.893; CI 1.649-9.194) was a significant predictor of mortality in IE patients, together with advanced age (P = 0.005; HR 3.138; CI 1.421-6.930) and prosthetic valve IE (P = 0.008; HR 2.819; CI 1.315-6.044).

CONCLUSIONS:
IE can give rise to various forms of CVC, most frequently, acute ischemic brain lesions. In our study, major CVC was associated with high risk of mortality although total CVC was not significantly related to the risk of death in patients with IE.
Department
Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
Publisher
School of Medicine
Citation
BMC Neurology, Vol.14(1) : 30-30, 2014
Type
Article
ISSN
1471-2377
DOI
10.1186/1471-2377-14-30
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35245
Authorize & License
  • AuthorizeOpen
Files in This Item:

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.