Journal article

Analysis of the Impact of Early Surgery on In-Hospital Mortality of Native Valve Endocarditis Use of Propensity Score and Instrumental Variable Methods to Adjust for Treatment-Selection Bias

Tahaniyat Lalani, Christopher H Cabell, Daniel K Benjamin, Ovidiu Lasca, Christoph Naber, Vance G Fowler, G Ralph Corey, Vivian H Chu, Michael Fenely, Orathai Pachirat, Ru-San Tan, Richard Watkin, Adina Ionac, Asuncion Moreno, Carlos A Mestres, Jose Casabe, Natalia Chipigina, Damon P Eisen, Denis Spelman, Francois Delahaye Show all

Circulation | LIPPINCOTT WILLIAMS & WILKINS | Published : 2010

Abstract

BACKGROUND: The impact of early surgery on mortality in patients with native valve endocarditis (NVE) is unresolved. This study sought to evaluate valve surgery compared with medical therapy for NVE and to identify characteristics of patients who are most likely to benefit from early surgery. METHODS AND RESULTS: Using a prospective, multinational cohort of patients with definite NVE, the effect of early surgery on in-hospital mortality was assessed by propensity-based matching adjustment for survivor bias and by instrumental variable analysis. Patients were stratified by propensity quintile, paravalvular complications, valve perforation, systemic embolization, stroke, Staphylococcus aureus ..

View full abstract

Grants

Awarded by Spanish Network for the Research in Infectious Diseases


Awarded by National Institutes of Health


Awarded by American Heart Association


Awarded by NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES


Funding Acknowledgements

Grants were received from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Madrid, Spain, the Spanish Network for the Research in Infectious Diseases (REIPI RD06/0008), and Fundacion Privada Maximo Soriano Jimenez, Barcelona, Spain (grant supporting the Hospital Clnic Endocarditis database; Dr Moreno); and the National Institutes of Health (Dr Fowler; grant no. R01-AI068804). This study was supported by a grant from the American Heart Association (3830047) to Dr Wang. The funding source had no role in the design or conduct of the study. The ICE project has also received funding from investigator donations (Bruno Barsic, Dr Corey, Dr Fowler, David Gordon, Dr Wang) and educational grants (Cubist Pharmaceuticals, International Society of Cardiovascular Infectious Diseases).