Outcome after surgical treatment performed within the first week of antimicrobial therapy during XXXX : a prospective study.

@entity1 @entity73 @entity340 @entity204 @entity65 @entity884
BACKGROUND: An increasing number of @entity1 with @entity884 ( @entity884 ) are operated on before the end of the first week of antimicrobial therapy. The mortality and morbidity of this specific group are unknown. AIMS: To evaluate the outcome of @entity1 with @entity884 requiring cardiac surgery performed within the first week of antimicrobial therapy. METHODS: All consecutive @entity1 with a definite diagnosis of @entity884 operated on within the first week of antimicrobial therapy were followed prospectively. Endpoints were in-hospital mortality and a combined endpoint of long-term @entity65 , recurrence and @entity340 (PVD). The three main conditions requiring surgery, namely haemodynamic @entity73 and periannular extension, were tested as potential predictors of outcome after adjustment for relevant variables. RESULTS: Among the 95 @entity1 included, surgery was performed a median time of 3 days after starting antimicrobial therapy. In-hospital mortality was 15%. The 3-year cumulative rates of the combined endpoint and of @entity65 were 38+/-7% and 27+/-7%, respectively. Recurrence occurred in 12% and PVD in 7%. Periannular extension was the main predictor of in-hospital @entity204 and the combined endpoint. CONCLUSION: Despite the short time between starting antimicrobial therapy and performing surgery, the risk of @entity204 , recurrence and PVD does not appear excessively high. In the presence of periannular extension, however, surgery is associated with a greater risk of postoperative events.
