Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11855
Title: Age adjusted Charlson Co-morbidity Index is an independent predictor of mortality over long-term follow-up in infective endocarditis.
Authors: Lu, K J;Kearney, Leighton G;Ord, M;Jones, Elizabeth F;Burrell, Louise M;Srivastava, Piyush M
Affiliation: Department of Medicine, University of Melbourne and Austin Health, Victoria, Australia; Department of Cardiology, Austin Health, Victoria, Australia. Electronic address: ken.lu@austin.org.au.
Issue Date: 15-Aug-2013
Citation: International Journal of Cardiology 2013; 168(6): 5243-8
Abstract: Infective endocarditis (IE) is associated with high morbidity and mortality. The epidemiology of IE is changing, affecting more elderly patients with increased medical comorbidities. We aimed to assess the ability of the age adjusted Charlson Co-morbidity Index (ACCI) to predict early and late outcomes.Between 1998 and 2010, adult patients with definite IE according to the modified Duke criteria were identified. The primary outcome was in-hospital and all-cause mortality. The secondary outcome was predictors of the primary outcome incorporating ACCI.148 patients with IE were followed up for a mean of 3.8 ± 3 years. The mean age was 57 ± 17 years and 66% were male. In-hospital mortality and all-cause mortality were 24 and 47% respectively. Comorbid conditions included diabetes mellitus (DM) (21%); ischaemic heart disease (16%); heart failure (HF) (14%); renal failure (eGFR <60 ml/min/1.73 m(2)) (19%); and anaemia (64%). The most common causative organism was Staphylococcus aureus (53%). ACCI was >3 in 59% of patients. Cardiac surgery was performed in 45% of patients. On Cox regression analysis, ACCI >3 (HR=3.0 [1.5-6.0], p<0.002), new onset HF (HR=2.2 [1.3-3.6], p<0.003), anaemia (HR=1.8 [1.1-3.2], p=0.04) and age-per decade (HR=1.4 [1.1-1.7]. p=0.004) were independently associated with all-cause mortality. ACCI >3 was the strongest predictor of in-hospital mortality (OR=8.4 [2.8-24], p<0.001). Of the individual ACCI components, prior HF, DM with complications and metastatic disease were independent predictors of all-cause mortality.In-hospital and all-cause mortality of IE remain high. An ACCI >3 was a strong predictor of mortality, in addition to age, new HF and anaemia.
Internal ID Number: 23978361
URI: http://ahro.austin.org.au/austinjspui/handle/1/11855
DOI: 10.1016/j.ijcard.2013.08.023
URL: http://www.ncbi.nlm.nih.gov/pubmed/23978361
Type: Journal Article
Subjects: Charlson Co-morbidity Index
Infective endocarditis
Mortality
Adult
Age Distribution
Aged
Anemia.mortality
Comorbidity
Endocarditis, Bacterial.mortality
Female
Follow-Up Studies
Heart Failure.mortality
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Retrospective Studies
Risk Factors
Staphylococcal Infections.mortality
Streptococcal Infections.mortality
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.