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Predictors of mortality in paravalvular abscess
Tasneem Z Naqvi1, Jason Boyatt, Robert J Siegel
1Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, California, USA. tasneem.naqvi@cshs.org
Summary
Paravalvular abscess, a complication of infective endocarditis, has poorly defined prognostic factors. Neurologic impairment and renal impairment significantly impact survival in these patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Paravalvular abscess is a serious complication of infective endocarditis.
- Prognostic factors for paravalvular abscess are not well understood.
Purpose of the Study:
- To identify prognostic variables in patients with paravalvular abscess.
- To analyze clinical, echocardiographic, microbiologic, and surgical data.
Main Methods:
- Retrospective review of 45 patients with paravalvular abscess (1987-2004).
- Analysis of clinical, echocardiographic, microbiologic, and surgical data.
- Comparison of outcomes between survivors and non-survivors.
Main Results:
- Common organisms included Staphylococcus aureus. 84% underwent surgery during initial admission.
- Surgical mortality was 7%, in-hospital mortality 31%, and 1-year mortality 38%.
- Patients who died had higher rates of stroke/altered mental status and worse renal function (creatinine).
Conclusions:
- Neurologic impairment and renal impairment are significant predictors of 1-year survival.
- These factors are crucial for risk stratification in paravalvular abscess cases.