| アイテムタイプ |
itemtype_ver1(1) |
| 公開日 |
2024-09-09 |
| タイトル |
|
|
タイトル |
Optimal surgical timing for non-urgent surgery patients with active infective endocarditis |
|
言語 |
en |
| 著者 |
Uemura, Tomonari
Ito, Hideki
Yamamoto, Ryota
Yamamoto, Toshikuni
Terazawa, Sachie
Yoshizumi, Tomo
Tokuda, Yoshiyuki
Narita, Yuji
Mutsuga, Masato
|
| アクセス権 |
|
|
アクセス権 |
open access |
|
アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
| 権利 |
|
|
権利情報Resource |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
|
権利情報 |
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International |
|
言語 |
en |
| キーワード |
|
|
主題Scheme |
Other |
|
主題 |
infective endocarditis |
| キーワード |
|
|
主題Scheme |
Other |
|
主題 |
non-urgent surgery |
| キーワード |
|
|
主題Scheme |
Other |
|
主題 |
prognostication |
| 内容記述 |
|
|
内容記述タイプ |
Abstract |
|
内容記述 |
While preoperative antibiotic therapy is generally recommended in non-emergency surgery cases of infective endocarditis, delaying surgery may lead to a deterioration in patient condition. This study examined deterioration of condition during preoperative antibiotic therapy and associated clinical characteristics to clarify the optimal timing for non-emergent infective endocarditis surgery. We retrospectively analyzed 65 patients (mean age 57.1 ± 16.9 years) with active left-sided infective endocarditis (57 with native valves, 8 with prosthetic valves) initially considered suitable for combined antibiotic therapy and non-emergent surgical treatment. Causative organisms were Streptococcus spp. (n=31), Staphylococcus spp. (n=15, including 5 resistant strains), and Gram-negative bacteria (n=4). Twelve patients (18%) required unexpected urgent operations shortly after starting antibiotics (median 5.5 days, interquartile range 3–8 days). Another 12 patients (18%) experienced deterioration of condition 20–30 days after starting antibiotics, including worsening heart failure (n=5), new embolic events (n=3), new perivalvular extension of infection (n=3), and worsening infection parameters (n=1). A leukocyte count >7900/μL one week after starting antibiotics predicted late deterioration (sensitivity 91%, specificity 76%, area under the receiver operating characteristic curve 0.866). Among patients with active infective endocarditis who initially received maximal antibiotic therapy and were considered for non-emergent surgery, 18% required urgent operation and another 18% experienced late deterioration. A high leukocyte count despite one week of antibiotic therapy was associated with late deterioration. For these patients, earlier surgical intervention might be beneficial to avoid a deterioration in conditions. |
|
言語 |
en |
| 出版者 |
|
|
出版者 |
Nagoya University Graduate School of Medicine, School of Medicine |
|
言語 |
en |
| 言語 |
|
|
言語 |
eng |
| 資源タイプ |
|
|
資源タイプresource |
http://purl.org/coar/resource_type/c_6501 |
|
タイプ |
departmental bulletin paper |
| 出版タイプ |
|
|
出版タイプ |
VoR |
|
出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| ID登録 |
|
|
ID登録 |
10.18999/nagjms.87.3.546 |
|
ID登録タイプ |
JaLC |
| 関連情報 |
|
|
関連タイプ |
isVersionOf |
|
|
識別子タイプ |
URI |
|
|
関連識別子 |
https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/873.html |
| 収録物識別子 |
|
|
収録物識別子タイプ |
PISSN |
|
収録物識別子 |
0027-7622 |
| 収録物識別子 |
|
|
収録物識別子タイプ |
EISSN |
|
収録物識別子 |
2186-3326 |
| 書誌情報 |
en : Nagoya Journal of Medical Science
巻 87,
号 3,
p. 546-557,
発行日 2025-08
|
15_Uemura.pdf (1.0 MB)
.png)
