Preoperative fibrinogen level predicts the risk and prognosis of patients with native valve infective endocarditis undergoing valve surgery

PeerJ. 2024 Sep 25:12:e18182. doi: 10.7717/peerj.18182. eCollection 2024.

Abstract

Aim: The aim of this study was to assess the clinical significance and prognostic value of the preoperative fibrinogen (FBG) level in patients with native valve infective endocarditis (NVIE) who underwent valve surgery.

Methods: This retrospective study included a total of 163 consecutive patients who were diagnosed with NVIE and underwent valve surgery from January 2019 to January 2022 in our hospital. The primary endpoint was all-cause mortality.

Results: All-cause mortality was observed in 9.2% of the patients (n = 15). Body mass index (BMI) was lower in the survival group (p = 0.025), whereas FBG (p = 0.008) and platelet count (p = 0.044) were significantly greater in the survival group than in the death group. Multivariate Cox proportional hazards analysis revealed that FBG (HR, 0.55; 95% CI, [0.32-0.94]; p = 0.029) was an independent prognostic factor for all-cause mortality. Furthermore, Kaplan‒Meier survival curve analysis revealed that patients with low FBG levels (<3.28 g/L) had a significantly greater mortality rate (p = 0.034) than did those with high FBG levels (>3.99 g/L). In the trend analysis, the FBG tertiles were significantly related to all-cause mortality in all three adjusted models, and the p values for trend were 0.017, 0.016, and 0.028, respectively.

Conclusion: Preoperative FBG may serve as a prognostic factor for all-cause mortality, and an FBG concentration less than 3.28 g/L was associated with a greater risk of all-cause mortality in NVIE patients undergoing valve surgery.

Keywords: All-cause mortality; Fibrinogen; Native valve infective endocarditis; Prognostic factor; Valve surgery.

MeSH terms

  • Adult
  • Aged
  • Endocarditis* / blood
  • Endocarditis* / mortality
  • Endocarditis* / surgery
  • Female
  • Fibrinogen* / analysis
  • Fibrinogen* / metabolism
  • Heart Valve Diseases / blood
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / surgery
  • Heart Valves / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors

Substances

  • Fibrinogen

Grants and funding

This study were supported by the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) (No. 2022MSXM115) and the Chongqing National Science Foundation General Project (CSTB2022NSCQ-MSX1249). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.