Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain
Por:
Barca, LV, Vidal-Bonnet, L, Farinas, MC, Munoz, P, Minero, MV, de Alarcon, A, Carretero, EG, Cuadra, MG, Camacho, AM, Urkola, XK, Agirre, JG, Burgos, GO, Lopez-Cortes, LE, Azpiroz, JCP, Lopez-Menendez, J, Benito N., GAMES Investigators
Publicada:
1 nov 2021
Resumen:
Introduction Sex-dependent differences of infective endocarditis (IE) have been reported. Women suffer from IE less frequently than men and tend to present more severe manifestations. Our objective was to analyse the sex-based differences of IE in the clinical presentation, treatment, and prognosis. Material and methods We analysed the sex differences in the clinical presentation, modality of treatment and prognosis of IE in a national-level multicentric cohort between 2008 and 2018. All data were prospectively recorded by the GAMES cohort (Spanish Collaboration on Endocarditis). Results A total of 3451 patients were included, of whom 1105 were women (32.0%). Women were older than men (mean age, 68.4 vs 64.5). The most frequently affected valves were the aortic valve in men (50.6%) and mitral valve in women (48.7%). Staphylococcus aureus aetiology was more frequent in women (30.1% vs 23.1%; p<0.001). Surgery was performed in 38.3% of women and 50% of men. After propensity score (PS) matching for age and estimated surgical risk (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II)), the analysis of the matched cohorts revealed that women were less likely to undergo surgery (OR 0.74; 95% CI 0.59 to 0.91; p=0.05). The observed overall in-hospital mortality was 32.8% in women and 25.7% in men (OR for the mortality of female sex 1.41; 95% CI 1.21 to 1.65; p<0.001). This statistical difference was not modified after adjusting for all possible confounders. Conclusions Female sex was an independent factor related to mortality after adjusting for confounders. In addition, women were less frequently referred for surgical treatment.
Filiaciones:
Barca, LV:
Hosp Univ Fdn Jimenez Diaz, Cardiac Surg, Madrid 28034, Spain
Vidal-Bonnet, L:
Hosp Univ Son Espases, Serv Cirugia Cardiaca, Palma De Mallorca, Illes Balears, Spain
Farinas, MC:
Marques de Valdecilla Fdn, Serv Enfermedades Infecciosas, Santander, Cantabria, Spain
Munoz, P:
Gregorio Maranon Gen Univ Hosp, Serv Microbiol Clin & Enfermedades Infecciosas, Cardiol Serv, Madrid, Spain
Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon, Fac Med, CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
Minero, MV:
Gregorio Maranon Gen Univ Hosp, Serv Microbiol Clin & Enfermedades Infecciosas, Cardiol Serv, Madrid, Spain
de Alarcon, A:
Virgen del Rocio Univ Hosp, Serv Enfermedades Infecciosas, Seville, Spain
Carretero, EG:
Virgen del Rocio Univ Hosp, Cardiac Surg, Seville, Spain
Cuadra, MG:
Marques de Valdecilla Fdn, Serv Enfermedades Infecciosas, Santander, Cantabria, Spain
Camacho, AM:
Clin Barcelona Hosp Univ, Serv Enfermedades Infecciosas, Barcelona, Spain
Urkola, XK:
Donostia Ospitalea, Serv Enfermedades Infecciosas, San Sebastian, Spain
Agirre, JG:
Cruces Univ Hosp, Serv Enfermedades Infecciosas, Barakaldo, Baracaldo, Pais Vasco, Spain
Burgos, GO:
Univ Hosp Virgen de la Victoria, Unidad Gest Clin Enfermedades Infecciosas Microbi, Malaga, Spain
Lopez-Cortes, LE:
Complejo Hosp Virgen de la Macarena, Unidad Clin Enfermedades Infecciosas Microbiol &, Seville, Spain
Azpiroz, JCP:
Miguel Servet Univ Hosp, Serv Cardiol, Zaragoza, Spain
Lopez-Menendez, J:
Hosp Univ Ramon y Cajal, Cardiac Surg, Madrid, Spain
Benito N.:
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
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