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Analysis of sex differences in the clinical presentation, management and prognosis of infective endocarditis in Spain

流行病学 介绍(产科) 外科 入射(几何) 重症监护医学 儿科 心脏病 疾病 回顾性队列研究
作者
Laura Barca,Laura Vidal-Bonnet,Fariñas Mc,Patricia Muñóz,Maricela Valerio Minero,Arı́stides de Alarcón,Encarnación Gutiérrez Carretero,Manuel Cuadra,A. Camacho,Xabier Kortajarena Urkola,Josune Goikoetxea Agirre,Guillermo Ojeda-Burgos,Luis Eduardo López-Cortés,JC Porres Azpiroz,José López-Menéndez
出处
期刊:Heart [BMJ]
卷期号:107 (21): 1717-1724 被引量:11
标识
DOI:10.1136/heartjnl-2021-319254
摘要

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.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).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.Female sex was an independent factor related to mortality after adjusting for confounders. In addition, women were less frequently referred for surgical treatment.
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