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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | Stroke | Research article

Midterm outcomes of early versus late surgery for infective endocarditis with neurologic complications: a meta-analysis

Authors: Yujiro Yokoyama, Taichiro Goto

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Cerebral infarction (CI) remains one of the most common and fatal complications of infective endocarditis (IE), and the timing of surgery for IE with neurologic complications is controversial. As outcomes beyond the perioperative period have not been assessed with a meta-analysis previously, we conducted a meta-analysis comparing mid- to long-term outcomes of early and late surgery in patients with IE and neurologic complications.

Methods

All studies that investigated early and late surgery in patients with IE and neurologic complications were identified. The primary and secondary endpoints were all-cause mortality and recurrence, respectively. Hazard ratios (HRs) for all-cause mortality and recurrence were extracted from each study.

Results

Our search identified five eligible studies, which were all observational studies consisting of a total of 624 patients with IE and neurologic complications. Pooled analyses demonstrated that all-cause mortality was similar between the early and late surgery groups (HR [95% confidence interval [CI]] = 0.90 [0.49–1.64]; P = 0.10; I² = 49%). Similarly, the recurrence rates were similar between both groups (HR [95% CI] = 1.86 [0.76–4.52]; P = 0.43; I² = 0%).

Conclusions

Our meta-analysis showed similar mortality and recurrent rates between the early and late surgery groups. The optimal timing of surgery should be individualized on a case-to-case basis.

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Title: Midterm outcomes of early versus late surgery for infective endocarditis with neurologic complications: a meta-analysis
Authors: Yujiro Yokoyama
Taichiro Goto
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Stroke
Endocarditis
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01425-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Midterm outcomes of early versus late surgery for infective endocarditis with neurologic complications: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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