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Similar Outcomes in Males and Females Undergoing Surgery for Infective Endocarditis
Dror B Leviner1,2, Itay Schultz2, Tom Friedman2,3
1Department of Cardiothoracic Surgery, Carmel Medical Center, Haifa 3436212, Israel.
Insights
This study found no significant sex-based differences in mortality for patients undergoing surgery for infective endocarditis. Key risk factors like diabetes and age were similar between sexes, contributing to comparable survival rates.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Sex-based disparities in mortality have been noted in infective endocarditis patients.
- Previous observations prompted an investigation into the underlying risk factors for these differences.
Purpose of the Study:
- To evaluate the risk factors contributing to sex-based mortality differences in surgically treated infective endocarditis.
- To compare short- and long-term mortality rates between female and male patients.
Main Methods:
- Retrospective cohort study involving 376 patients from three Israeli centers.
- Analysis of short-term and long-term mortality, alongside risk factor comparison between sexes.
Main Results:
- Female patients exhibited higher rates of hypertension, Gram-negative infections, and mitral valve replacement.
- Diabetes and age were primary mortality predictors, with no significant sex-based difference.
- In-hospital mortality (29% vs. 26%) and long-term mortality (46% vs. 36%) showed no statistical difference between sexes.
Conclusions:
- No statistically significant difference in short- and long-term mortality was observed between female and male patients.
- Similar rates of critical risk factors (diabetes, age) likely explain the comparable mortality outcomes.
- A trend of decreasing mortality over the past decade and a favorable prognosis for patients surviving the initial 30 days post-surgery were noted.
Abstract:
Background: Sex-based differences in mortality have been previously observed in patients with surgically treated infective endocarditis. We sought to evaluate the risk factors leading to this difference. Methods: A retrospective cohort from three centers in Israel comprising 376 surgically treated patients, comparing short- and long-term mortality rates and risk factors between female and male patients. Results: Compared to male patients, female patients had higher rates of hypertension (62% vs. 48%), higher rates of Gram-negative infections (20% vs. 11%), and more mitral valve replacement (55% vs. 42%). Diabetes and age were the most significant predictors for mortality and did not differ between female and male patients. In-hospital mortality rates did not differ between female and male patients (29% vs. 26%), and the difference in long-term mortality was not statistically significant (46% vs. 36% p = 0.088). Conclusions: No statistical difference was observed in short- and long-term mortality between female and male patients, most likely due to a lack of difference in the rates of important risk factors such as diabetes and age. Mortality rates decreased in the last 10 years, and a good prognosis is observed for patients surviving the initial 30 days after surgery.
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