Friedrich Christine, Salem Mohamed, Puehler Thomas, Panholzer Bernd, Herbers Lea, Reimers Julia, Hummitzsch Lars, Cremer Jochen, Haneya Assad
Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
J Clin Med. 2022 Mar 28;11(7):1875. doi: 10.3390/jcm11071875.
(1) Background: Surgery for infective endocarditis (IE) is associated with considerable mortality and it is controversial whether the female gender is predictive for a worse outcome. This large single-center study investigated the impact of sex on outcomes after surgery for IE. (2) Methods: 413 patients (25.4% female) were included into this retrospective observational study. Univariate and multivariable analyses identified sex-specific risk factors for 30 day and late mortality. Survival was estimated by the Kaplan-Meier-method. (3) Results: Women presented more often with mitral valve infection (p = 0.039). Men presented more frequently with previous endocarditis (p = 0.045), coronary heart disease (p = 0.033), and aortic valve infection (p = 0.005). Blood transfusion occurred more frequently intraoperatively in women (p < 0.001), but postoperatively in men (p = 0.015) and men had a longer postoperative stay (p = 0.046). Women showed a higher 30 day mortality than men (p = 0.007) and female gender was predictive for 30 day mortality (OR 2.090). Late survival showed no sex-specific difference (p = 0.853), and the female gender was not an independent predictor for late mortality (p = 0.718). Risk factors for early and late mortality showed distinct sex-specific differences such as increased preoperative CRP level in women and culture-negative IE in men.
(1) 背景：感染性心内膜炎（IE）手术的死亡率颇高，女性性别是否预示着更差的预后存在争议。这项大型单中心研究调查了性别对IE手术后结局的影响。(2) 方法：413例患者（25.4%为女性）纳入这项回顾性观察研究。单因素和多因素分析确定了30天和晚期死亡率的性别特异性危险因素。采用Kaplan-Meier法估计生存率。(3) 结果：女性二尖瓣感染更为常见（p = 0.039）。男性既往心内膜炎（p = 0.045）、冠心病（p = 0.033）和主动脉瓣感染更为频繁（p = 0.005）。女性术中输血更为频繁（p < 0.001），但男性术后输血更频繁（p = 0.015），且男性术后住院时间更长（p = 0.046）。女性30天死亡率高于男性（p = 0.007），女性性别可预测30天死亡率（OR 2.090）。晚期生存率无性别特异性差异（p = 0.853），女性性别不是晚期死亡率的独立预测因素（p = 0.718）。早期和晚期死亡率的危险因素存在明显的性别特异性差异，如女性术前CRP水平升高和男性血培养阴性的IE。
