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Master Thesis

Comparaison des caractéristiques cliniques, biologiques, iconographiques et du pronostic des aortites inflammatoires et infectieuses

Abstract : Background: aortitis etiological diagnosis is often challenging, particularly between infectious aortitis (IA) and non-infectious aortitis (NIA). This study aims to describe and compare the clinical, biological and radiological characteristics of IA and NIA and their outcomes. Methods: a multicentric retrospective study was performed in 10 French centers, including patients who have been diagnosed with aortitis between January 1st, 2014 and December 31st, 2019. Results: IA was diagnosed in 66 patients, mainly due to Enterobacterales and streptococci in 20% of cases respectively, followed by Staphylococcus aureus and Coxiella burnetii. NIA was diagnosed in 117 patients with a majority of systemic diseases (56.4%, mainly vasculitis) and idiopathic aortitis (39.3%). There were more aortic aneurysms in IA (78.8% vs 17.6% in NIA, p<0.001) and more infra-renal localizations (60.6% vs 17.9% in NIA, p<0.001). Crude survival was significantly lower in IA compared to NIA group (p<0.001). Among IA, high ASA score (HR=2.47, p=0.033) and free aneurysm rupture (HR=9.54, 95%CI [0.67; 6.15], p=0.046) was significantly associated with mortality after adjusting for age, sex, and Charlson’s comorbidity score. An effective empiric antimicrobial therapy, initiated before any microbial documentation, was identified as a protective factor (HR=0.23, 95%CI [0.08; 0.71], p=0.01). No significant difference was found regarding surgical technique (open surgery vs endovascular treatment). Conclusion: IA have significantly higher mortality rates compared to NIA and therefore requires a quick diagnosis to introduce rapidly an optimal empiric antimicrobial therapy.
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Submitted on : Friday, November 12, 2021 - 10:07:39 AM
Last modification on : Friday, December 17, 2021 - 3:47:07 AM
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  • HAL Id : dumas-03426223, version 1

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Mathilde Carrer. Comparaison des caractéristiques cliniques, biologiques, iconographiques et du pronostic des aortites inflammatoires et infectieuses. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03426223⟩

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