Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis

Background: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE. Methods: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021. Results: Out of 5667 IE cases, 1125 had acute s...

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Autores: Álvarez Zaballos, Sara, Vázquez Alen, Pilar, Muñoz, Patricia, Alarcón González, Arístides de, Gutiérrez Carretero, Encarnación, Álvarez Uría, Ana, Fariñas Álvarez, María del Carmen, Rodríguez García, Raquel, Goenaga, Miguel Ángel, Cuervo, Guillermo, Plata Ciezar, Antonio, Hidalgo Tenorio, Carmen, Aldamiz Echevarría, Gonzalo, Martínez Sellés, Manuel
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/35700
Acceso en línea:https://hdl.handle.net/10902/35700
Access Level:acceso abierto
Palabra clave:Infective endocarditis
Emboli
Mortality
Prognosis
Stroke
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spelling Prevalence and prognostic impact of stroke in a national cohort of infective endocarditisÁlvarez Zaballos, SaraVázquez Alen, PilarMuñoz, PatriciaAlarcón González, Arístides deGutiérrez Carretero, EncarnaciónÁlvarez Uría, AnaFariñas Álvarez, María del CarmenRodríguez García, RaquelGoenaga, Miguel ÁngelCuervo, GuillermoPlata Ciezar, AntonioHidalgo Tenorio, CarmenAldamiz Echevarría, GonzaloMartínez Sellés, ManuelInfective endocarditisEmboliMortalityPrognosisStrokeBackground: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE. Methods: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021. Results: Out of 5667 IE cases, 1125 had acute stroke (19.8%): 818 ischemic strokes (811 cardioembolic strokes (193 with hemorrhagic transformation), 4 transient ischemic attacks, 3 lacunar infarctions), 127 intracranial hemorrhages, and 27 other neurological complications (cerebral abscesses, encephalitis, and meningitis). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs 63.7%, p = 0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p = 0.01), surgical indication (69.9% vs 65.9%, p = 0.001), in-hospital mortality (40.9% vs 22.0%, p < 0.001), and 1-year mortality (46.2% vs 27.9%, p < 0.001). The following variables were independently associated with stroke: mitral location (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.34-1.8, p < 0.001), vascular phenomenon (OR = 2.9, 95% CI = 2.4-3.6, p = 0.0001), acute renal failure (OR = 1.2, 95% CI = 1.0-1.4, p = 0.021), septic shock (OR = 1.3, 95% CI = 1.1-1.6, p = 0.007), sepsis (OR = 1.3, 95% CI = 1.1-1.6, p = 0.005), surgery indicated but not performed (OR = 1.4, 95% CI = 1.2-1.7, p < 0.001), community-acquired IE (OR = 1.2, 95% CI = 1-1.4, p = 0.017), and peripheral embolization (OR = 1.6, 95% CI = 1.4-1.9, p < 0.001). Stroke was an independent predictor of in-hospital (OR = 2.1, 95% CI = 1.78-2.51, p < 0.001) and 1-year mortality (hazard ratio = 1.9, 95% CI = 1.6-2.5). Conclusion: One-fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.SAGE PublicationsUniversidad de Cantabria20242024-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/35700International journal of stroke : official journal of the International Stroke Society, 2024, 19(9), 989-998reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/357002026-06-02T12:39:31Z
dc.title.none.fl_str_mv Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
title Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
spellingShingle Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
Álvarez Zaballos, Sara
Infective endocarditis
Emboli
Mortality
Prognosis
Stroke
title_short Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
title_full Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
title_fullStr Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
title_full_unstemmed Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
title_sort Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
dc.creator.none.fl_str_mv Álvarez Zaballos, Sara
Vázquez Alen, Pilar
Muñoz, Patricia
Alarcón González, Arístides de
Gutiérrez Carretero, Encarnación
Álvarez Uría, Ana
Fariñas Álvarez, María del Carmen
Rodríguez García, Raquel
Goenaga, Miguel Ángel
Cuervo, Guillermo
Plata Ciezar, Antonio
Hidalgo Tenorio, Carmen
Aldamiz Echevarría, Gonzalo
Martínez Sellés, Manuel
author Álvarez Zaballos, Sara
author_facet Álvarez Zaballos, Sara
Vázquez Alen, Pilar
Muñoz, Patricia
Alarcón González, Arístides de
Gutiérrez Carretero, Encarnación
Álvarez Uría, Ana
Fariñas Álvarez, María del Carmen
Rodríguez García, Raquel
Goenaga, Miguel Ángel
Cuervo, Guillermo
Plata Ciezar, Antonio
Hidalgo Tenorio, Carmen
Aldamiz Echevarría, Gonzalo
Martínez Sellés, Manuel
author_role author
author2 Vázquez Alen, Pilar
Muñoz, Patricia
Alarcón González, Arístides de
Gutiérrez Carretero, Encarnación
Álvarez Uría, Ana
Fariñas Álvarez, María del Carmen
Rodríguez García, Raquel
Goenaga, Miguel Ángel
Cuervo, Guillermo
Plata Ciezar, Antonio
Hidalgo Tenorio, Carmen
Aldamiz Echevarría, Gonzalo
Martínez Sellés, Manuel
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Infective endocarditis
Emboli
Mortality
Prognosis
Stroke
topic Infective endocarditis
Emboli
Mortality
Prognosis
Stroke
description Background: Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE. Methods: Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021. Results: Out of 5667 IE cases, 1125 had acute stroke (19.8%): 818 ischemic strokes (811 cardioembolic strokes (193 with hemorrhagic transformation), 4 transient ischemic attacks, 3 lacunar infarctions), 127 intracranial hemorrhages, and 27 other neurological complications (cerebral abscesses, encephalitis, and meningitis). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs 63.7%, p = 0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p = 0.01), surgical indication (69.9% vs 65.9%, p = 0.001), in-hospital mortality (40.9% vs 22.0%, p < 0.001), and 1-year mortality (46.2% vs 27.9%, p < 0.001). The following variables were independently associated with stroke: mitral location (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.34-1.8, p < 0.001), vascular phenomenon (OR = 2.9, 95% CI = 2.4-3.6, p = 0.0001), acute renal failure (OR = 1.2, 95% CI = 1.0-1.4, p = 0.021), septic shock (OR = 1.3, 95% CI = 1.1-1.6, p = 0.007), sepsis (OR = 1.3, 95% CI = 1.1-1.6, p = 0.005), surgery indicated but not performed (OR = 1.4, 95% CI = 1.2-1.7, p < 0.001), community-acquired IE (OR = 1.2, 95% CI = 1-1.4, p = 0.017), and peripheral embolization (OR = 1.6, 95% CI = 1.4-1.9, p < 0.001). Stroke was an independent predictor of in-hospital (OR = 2.1, 95% CI = 1.78-2.51, p < 0.001) and 1-year mortality (hazard ratio = 1.9, 95% CI = 1.6-2.5). Conclusion: One-fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/35700
url https://hdl.handle.net/10902/35700
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SAGE Publications
publisher.none.fl_str_mv SAGE Publications
dc.source.none.fl_str_mv International journal of stroke : official journal of the International Stroke Society, 2024, 19(9), 989-998
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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