Table 5. Characteristics of patients with PVE and surgical indication according to whether the patient underwent surgery.
| Surgery performed (n = 650) | Surgery not performed (n = 359) | p-value | |
|---|---|---|---|
| Age. years (IQR) | 69 (59–75) | 73 (65–79) | <0.001 |
| Male gender | 449 (69.0) | 233 (64.9) | 0.175 |
| Hospital-acquired | 247 (38.0) | 158 (44.0) | 0.062 |
| Site of infection | |||
| Aortic | 477 (73.4) | 264 (73.5) | 0.958 |
| Mitral | 229 (35.2) | 147 (40.9) | 0.072 |
| Tricuspid | 7 (1.1) | 8 (2.2) | 0.148 |
| Pulmonary | 11 (1.7) | 9 (2.5) | 0.374 |
| Comorbidity | |||
| Chronic heart failure | 273 (42.0) | 195 (54.3) | 0.001 |
| Diabetes mellitus | 186 (28.6) | 107 (29.8) | 0.690 |
| Intravenous drug user | 5 (0.8) | 1 (0.3) | 0.571 |
| Peripheral vascular disease | 49 (7.5) | 42 (11.7) | 0.027 |
| Cerebrovascular disease | 111 (17.0) | 60 (16.7) | 0.883 |
| Neoplasia | 74 (11.3) | 75 (20.8) | <0.001 |
| Chronic renal failure | 137 (21.1) | 125 (34.8) | <0.001 |
| Chronic liver disease | 35 (5.3) | 42 (11.7) | <0.001 |
| Congenital heart disease | 53 (8.1) | 18 (5.0) | 0.062 |
| Age-adjusted Charlson index (IQR) | 4 (3–6) | 6 (4–8) | <0.001 |
| Early PVE | 255 (39.2) | 134 (37.3) | 0.552 |
| Late PVE | 395 (60.8) | 225 (62.7) | 0.552 |
| Microbiology | |||
| Gram-positive bacteria | |||
| Staphylococcus aureus | 86 (13.2) | 81 (22.6) | <0.001 |
| CoNS | 245 (37.7) | 120 (33.4) | 0.177 |
| Enterococcus | 88 (13.5) | 51 (14.2) | 0.768 |
| Streptococcus | 108 (16.6) | 57 (15.9) | 0.762 |
| Gram-negative bacilli | 20 (3.1) | 18 (5.0) | 0.122 |
| Anaerobic bacteria | 25 (3.8) | 0 | - |
| Fungi | |||
| Candida | 18 (2.8) | 11 (3.1) | 0.788 |
| Other fungal species | 1 (0.2) | 1 (0.3) | 0.670 |
| Polymicrobial | 8 (1.2) | 5 (1.4) | 0.827 |
| Other microorganisms | 23 (3.5) | 6 (1.7) | 0.089 |
| Echocardiographic findings | |||
| Vegetation | 460 (70.8) | 251 (69.9) | 0.776 |
| Intracardiac complications | 373 (57.4) | 158 (44.0) | <0.001 |
| Valve perforation or rupture | 35 (5.3) | 14 (3.9) | 0.293 |
| Pseudoaneurysm | 91 (14.0) | 45 (12.5) | 0.514 |
| Perivalvular abscess | 311 (47.8) | 120 (33.4) | <0.001 |
| Intracardiac fistula | 43 (6.6) | 17 (4.7) | 0.227 |
| Clinical course | |||
| Acute heart failure | 294 (45.2) | 177 (49.3) | 0.214 |
| Persistent bacteremia | 67 (10.3) | 51 (14.2) | 0.065 |
| Stroke | 146 (22.4) | 102 (28.4) | 0.036 |
| Embolism a | 146 (22.4) | 82 (22.8) | 0.89 |
| Acute renal failure | 289 (44.4) | 169 (47.0) | 0.425 |
| Septic shock | 74 (11.3) | 86 (23.9) | <0.001 |
| In-hospital mortality | 203 (31.3) | 184 (51.3) | <0.001 |
| First year mortality | 232 (35.7) | 201 (55.9) | <0.001 |
| Recurrence | 7 (1.5) | 4 (2.8) | 0.540 |
IQR: Interquartile range. CoNS: Coagulase-negative staphylococci.
a Excluding cases with stroke