Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/124566
Title: Infective endocarditis in patients with cancer: a consequence of invasive procedures or a harbinger of neoplasm?. A prospective, multicenter cohort.
Author: Fernández-Cruz, Ana
Muñoz, Patricia
Sandoval, Carmen
Fariñas, María Carmen
Gutiérrez-Cuadra, Manuel
Pericàs, Juan M.
Miró Meda, José M.
Goenaga Sánchez, Miguel Ángel
Alarcón, Aristides de
Bonache-Bernal, Franscisco
Rodríguez, Mª Ángeles
Noureddine, Mariam
Bouza Santiago, Emilio
Keywords: Endocarditis
Càncer
Estudi de casos
Endocarditis
Cancer
Case studies
Issue Date: 1-Sep-2017
Publisher: Lippincott, Williams & Wilkins. Wolters Kluwer Health
Abstract: The aim of the study was to draw a comparison between the characteristics of infective endocarditis (IE) in patients with cancer and those of IE in noncancer patients.Patients with IE, according to the modified Duke criteria, were prospectively included in the GAMES registry between January 2008 and February 2014 in 30 hospitals. Patients with active cancer were compared with noncancer patients.During the study period, 161 episodes of IE fulfilled the inclusion criteria. We studied 2 populations: patients whose cancer was diagnosed before IE (73.9%) and those whose cancer and IE were diagnosed simultaneously (26.1%). The latter more frequently had community-acquired IE (67.5% vs 26.4%, P < .01), severe sepsis (28.6% vs 11.1%, P = .013), and IE caused by gastrointestinal streptococci (42.9% vs 16.8%, P < .01). However, catheter source (7.1% vs 29.4%, P = .003), invasive procedures (26.2% vs 44.5%, P = .044), and immunosuppressants (9.5% vs 35.6%, P = .002) were less frequent.When compared with noncancer patients, patients with cancer were more often male (75.2% vs 67.7%, P = .049), with a higher comorbidity index (7 vs 4). In addition, IE was more often nosocomial (48.7% vs 29%) and originated in catheters (23.6% vs 6.2%) (all P < .01). Prosthetic endocarditis (21.7% vs 30.3%, P = .022) and surgery when indicated (24.2% vs 46.5%, P < .01) were less common. In-hospital mortality (34.8% vs 25.8%, P = .012) and 1-year mortality (47.8% vs 30.9%, P < .01) were higher in cancer patients, although 30-day mortality was not (24.8% vs 19.3%, P = .087).A significant proportion of cases of IE (5.6%) were recorded in cancer patients, mainly as a consequence of medical interventions. IE may be a harbinger of occult cancer, particularly that of gastrointestinal or urinary origin.
Note: Reproducció del document publicat a: https://doi.org/10.1097/MD.0000000000007913
It is part of: Medicine, 2017, vol. 96, num. 38, p. e7913
URI: http://hdl.handle.net/2445/124566
Related resource: https://doi.org/10.1097/MD.0000000000007913
ISSN: 0025-7974
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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