Impact of Early Cardiac Surgery in Severe Left Endocarditis With Neurological Complications: a Retrospective Study

Study Overview
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Brief Summary
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Surgical delay in severe endocardits, with neurological complications, is still debated. Early surgery, if indicated, permits to avoid new embolic events, or to fix valvular damages, but can create or increase a cerebral hemorrage. Hypothesis Cardiac surgery, as soon as possible, if indicated, would reduce mortality, in severe left endocarditis, with neurological complications. Primary objective To assess the impact of early versus late cardiac surgery on mortality at 1 year, in patients with severe endocarditis, with neurological complications. Primary endpoint: 1) Mortality at 1 year Secondary endpoints: Analyze the factors associated with neurological degradation Evaluate the neurological tolerance of cardiac surgery.

Detailed Description
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Surgical delay in severe endocardits, with neurological complications, is still debated. Early surgery, if indicated, permits to avoid new embolic events, or to fix valvular damages, but can create or increase a cerebral hemorrage. Hypothesis Cardiac surgery, as soon as possible, if indicated, would reduce mortality, in severe left endocarditis, with neurological complications. Primary objective To assess the impact of early versus late cardiac surgery on mortality at 1 year, in patients with severe endocarditis, with neurological complications. Primary endpoint: 1) Mortality at 1 year Secondary endpoints: Analyze the factors associated with neurological degradation Evaluate the neurological tolerance of cardiac surgery. Methods Multicentric study (7 French university hospitals). Retrospective study: from august 2010 to december 2017. Propensity score matching study. 192 patients are included.

Official Title
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Impact of Cardiac Surgery in Severe Left Endocarditis With Neurological Complications: a Multicentric,Retrospective, Propensity-score Matching Study

Conditions
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Endocarditis, Neurologic Complication

Intervention / Treatment
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* Procedure: Cardiac surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Left endocarditis With indication of cardiac surgery Severe endocaditis (SOFA score > or = 3/16) With pre operative neurological complications Exclusion Criteria: Age < 18 Right endocarditis without left endocarditis No severe endocarditis (SOFA score < 3) Ne pre operative neurological complications Endocarditis without indication of cardiac surgery

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Cardiac surgery|Cardiac surgery, if indicated, delayed or not by neurological complications|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Death from any cause | at 1 year after the diagnosis of endocarditis | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurogical tolerance | Modified Rankin score after cardiac surgery, 0 (no symptoms at all) to 6 (death) | At 6 months |