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Factores de riesgo para la endocarditis infecciosa: higiene bucal y exposiciones no dentales
B L Strom1, E Abrutyn, J A Berlin
1Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Division of General Internal Medicine, University of Pennsylvania, Philadelpha 19104-6021, USA. Bstrom@cceb.med.upenn.edu
Circulation
|January 11, 2000
Resumen
La endocarditis infecciosa (IE) está relacionada con la enfermedad renal grave y la diabetes, no con los procedimientos médicos comunes. El uso diario del hilo dental puede reducir ligeramente el riesgo de IE de la flora dental.
Área de la Ciencia:
- Cardiología Cardiología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
Sus antecedentes:
- Los factores de riesgo para la endocarditis infecciosa (IE) no se comprenden bien.
- La identificación de factores de riesgo específicos es crucial para la prevención y la gestión.
Objetivo del estudio:
- Investigar la asociación entre diversas afecciones, procedimientos y endocarditis infecciosa adquirida en la comunidad (IE).
- Identificar los factores de riesgo modificables y no modificables para la IE en un estudio poblacional.
Principales métodos:
- Un estudio de caso-control basado en la población se llevó a cabo en el área de Filadelfia de 1988 a 1990.
- Los casos de IE adquiridos en la comunidad (excluyendo el uso de drogas intravenosas) se compararon con los residentes de la comunidad emparejados.
- Los factores de riesgo se evaluaron a través de entrevistas y se confirmaron mediante la revisión de registros médicos de expertos.
Principales resultados:
- La enfermedad renal grave (OR = 16.9) y la diabetes mellitus (OR = 2.7) se asociaron significativamente con un mayor riesgo de IE.
- Los pacientes con IE de la flora cutánea tenían tasas más altas de uso previo de líquidos intravenosos (OR = 6.7) e infecciones cutáneas.
- No se encontró ninguna asociación entre IE y recientes procedimientos pulmonares, GI, cardíacos o GU, o cirugía.
- Los pacientes edentulos tenían un menor riesgo de IE de la flora dental en comparación con aquellos con dientes que no se limpiaron diariamente.
Conclusiones:
- La endocarditis infecciosa (IE) se asocia con afecciones subyacentes específicas como enfermedad renal grave y diabetes.
- Los procedimientos médicos o dentales recientes no se identificaron como factores de riesgo significativos en este estudio.
- El uso diario de hilo dental mostró una disminución límite del riesgo de IE, lo que sugiere posibles medidas preventivas.
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