Surgical treatment on infective endocarditis: impact of diabetes on mortality.

Cardiovasc Diabetol

Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Published: June 2022

AI Article Synopsis

  • Type 2 diabetes is common among patients with infective endocarditis (IE) and this study aimed to assess its impact on mortality rates post-surgery for IE.
  • The study analyzed data from 420 patients over 14 years, dividing them into diabetic (Group II) and non-diabetic (Group I) to compare their outcomes.
  • While short- and intermediate-term mortality showed a trend towards being higher in diabetic patients, only 5-year mortality was significantly worse for diabetics, making diabetes a key factor in predicting long-term survival after treatment.

Article Abstract

Background: Type 2 diabetes mellitus (DM) is a frequent co-morbidity among patients suffering from infective endocarditis (IE). The aim of the study was to evaluate the impact of type 2 DM on the early-, intermediate- and long-term mortality of patients who underwent surgical treatment of endocarditis.

Methods: We performed an observational cohort study in the large tertiary center in Israel during 14 years. All data of patients who underwent surgical treatment of endocarditis, performed between 2006 and 2020 were extracted from the departmental database. Patients were divided into two groups: Group I (non-diabetic patients), and Group II (diabetic patients).

Results: The study population includes 420 patients. Group I (non-diabetic patients), comprise 326 patients, and Group II (diabetic patients), comprise 94 patients. Mean follow-up duration was 39.3 ± 28.1 months. Short-term, 30-day and in-hospital mortality, also intermediate-term mortality (1- and 3-year) was higher in the DM group compared with the non-DM group, but did not reach statistical significance: 11.7% vs. 7.7%. (p = 0.215); 12.8% vs. 8.3% (p = 0.285); 20.2% vs. 13.2% (p = 0.1) and 23.4% vs. 15.6% (p = 0.09) respectively. Long-term, 5-year mortality was significantly higher in the DM group, compared to the non-DM group: 30.9% vs. 16.6% (p = 0.003). Furthermore, predictors for long-term mortality included diabetes (CI 1.056-2.785, p = 0.029), as demonstrated by regression analysis.

Conclusions: Diabetic patients have trend to increasing mortality at the short- and intermediate period post-surgery for IE, but this is not statistically significant. Survival of diabetic patients deteriorates after more than three years follow surgery. Diabetes is an independent predictor for long-term, 5-year mortality after surgical treatment of endocarditis, regardless of the patients age and comorbidities. Trial registration Ethical Committee of Sheba Medical Centre, Israel on 02.12. 2014, Protocol 4257.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9248198PMC
http://dx.doi.org/10.1186/s12933-022-01557-xDOI Listing

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