Table 3.
Cox Proportional Hazards Modeling of Variables Independently Associated With In-Hospital and 1-Year Mortality, With Propensity Adjustment for Cardiac Surgery
| In-Hospital Mortality | 1-Year Mortality | |||
|---|---|---|---|---|
| Variable | No./Total (%) [95% CI] | HR (95% CI) | No./Total (%) [95% CI] | HR (95% CI) |
| Age, y | ||||
| ≤45 | 104/1036 (10.0) [8.2–11.9] | 1 [Reference] | 158/1040 (15.2) [13.0–17.4] | 1 [Reference] |
| 46–60 | 165/1071 (15.4) [13.2–17.6] | 2.06 (1.49–2.90) | 234/1071 (21.8) [19.4–24.3] | 1.44 (1.13–1.84) |
| 61–70 | 159/840 (18.9) [16.3–21.6] | 2.37 (1.70–3.36) | 208/840 (24.8) [21.8–27.7] | 1.62 (1.26–2.09) |
| >70 | 359/1209 (29.7) [27.1–32.3] | 3.76 (2.79–5.17) | 455/1213 (37.5) [34.8–40.2] | 2.40 (1.92–3.02) |
| ≥1 mo from symptoms of infective endocarditis to diagnosis |
||||
| No | 647/3075 (21.0) [19.6–22.5] | 1 [Reference] | 864/3081 (28.0) [26.5–29.6] | 1 [Reference] |
| Yes | 101/909 (11.1) [9.1–13.2] | 0.81 (0.66–0.99) | 138/911 (15.1) [12.8–17.5] | 0.75 (0.62–0.91) |
| Geographic region | ||||
| Europe | 446/2156 (20.7) [19.0–22.4] | 1 [Reference] | 553/2162 (25.6) [23.7–27.4] | 1 [Reference] |
| North America | 129/709 (18.2) [15.4–21.0] | 1.19 (0.95–1.48) | 228/710 (32.1) [28.7–35.5] | 0.98 (0.82–1.17) |
| South America | 73/372 (19.6) [15.6–23.7] | 1.40 (1.08–1.80) | 87/372 (23.4) [19.1–27.7] | 1.03 (0.82–1.29) |
| Other | 139/919 (15.1) [12.8–17.4] | 0.49 (0.37–0.62) | 187/920 (20.3) [17.7–22.9] | 0.47 (0.38–0.59) |
| Diabetes mellitus | ||||
| No | 560/3388 (16.5) [15.3–17.8] | 1 [Reference] | 762/3394 (22.5) [21.0–23.9] | 1 [Reference] |
| Yes | 208/700 (29.7) [26.3–33.1] | 1.33 (1.10–1.58) | 272/702 (38.7) [35.1–42.4] | 1.34 (1.14–1.57) |
| Health care–associated infection | ||||
| No | 436/3002 (14.5) [13.3–15.8] | 1 [Reference] | 584/3007 (19.4) [18.0–20.8] | 1 [Reference] |
| Yes | 306/949 (32.2) [29.3–35.2] | NAa | 412/951 (43.3) [40.2–46.5] | 2.02 (1.62–2.53) |
| Causative microorganism | ||||
| Viridans group streptococcus | ||||
| No | 727/3431 (21.2) [19.8–22.6] | 1 [Reference] | 964/3437 (28.0) [26.5–29.5] | 1 [Reference] |
| Yes | 60/725 (8.3) [6.3–10.3] | 0.65 (0.48–0.86) | 91/727 (12.5) [10.1–14.9] | 0.77 (0.59–0.98) |
| Streptococcus bovis | ||||
| No | 760/3884 (19.6) [18.3–20.8] | 1 [Reference] | 1015/3892 (26.1) [24.7–27.5] | 1 [Reference] |
| Yes | 27/272 (9.9) [6.4–13.5] | 0.45 (0.28–0.68) | 40/272 (14.7) [10.5–18.9] | 0.58 (0.40–0.82) |
| Staphylococcus aureus | ||||
| No | 458/2916 (15.7) [14.4–17.0] | 1 [Reference] | 623/2921 (21.3) [19.8–22.8] | 1 [Reference] |
| Yes | 329/1240 (26.5) [24.1–29.0] | NAa | 432/1243 (34.8) [32.1–37.4] | 1.31 (1.12–1.53) |
| Fungi | ||||
| No | 758/4086 (18.6) [17.4–19.7] | 1 [Reference] | 1016/4094 (24.8) [23.5–26.1] | 1 [Reference] |
| Yes | 29/70 (41.4) [29.9–53.0] | NAa | 39/70 (55.7) [44.1–67.4] | 1.77 (1.09–2.71) |
| NYHA class III or IV | ||||
| No | 382/2957 (12.9) [11.7–14.1] | 1 [Reference] | 560/2959 (18.9) [17.5–20.3] | 1 [Reference] |
| Yes | 316/910 (34.7) [31.6–37.8] | 3.38 (2.54–4.60) | 385/910 (42.3) [39.1–45.5] | 3.03 (2.45–3.80) |
| Paravalvular complication | ||||
| No | 521/3093 (16.8) [15.5–18.2] | 1 [Reference] | 720/3099 (23.2) [21.7–24.7] | 1 [Reference] |
| Yes | 250/1009 (24.8) [22.1–27.4] | 1.66 (1.42–1.95) | 315/1011 (31.2) [28.3–34.0] | 1.48 (1.28–1.70) |
| Stroke | ||||
| No | 485/3284 (14.8) [13.6–16.0] | 1 [Reference] | 704/3285 (21.4) [20.0–22.8] | 1 [Reference] |
| Yes | 276/800 (34.5) [31.2–37.8] | 1.61 (1.36–1.89) | 323/801 (40.3) [36.9–43.7] | 1.49 (1.28–1.72) |
| Surgery | ||||
| No | 463/2092 (22.1) [20.4–23.9] | 1 [Reference] | 634/2094 (30.3) [28.3–32.2] | 1 [Reference] |
| Yes | 321/2044 (15.7) [14.1–17.3] | 0.76 (0.58–0.99) | 415/2047 (20.3) [18.5–22.0] | 0.44 (0.34–0.56) |
Abbreviations: HR, hazard ratio; NYHA, New York Heart Association; NA, no association.
a
Variable not statistically associated with in-hospital mortality in the model (but associated with 1-year mortality in subsequent model).