感染症性内心炎における入院死亡の早期予測要因
Vivian H Chu1, Christopher H Cabell, Daniel K Benjamin
1Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Circulation
|March 24, 2004
まとめ
早期の臨床的要因は,エコーカルディオグラフィではなく,感染症性心内炎 (IE) による死亡率を予測します. これらの宿主-病原体相互作用を特定することは,IE患者のより良い結果のための積極的な治療を導くことができます.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- クリニカル・メディシン 臨床医学
背景:
- 感染性内心炎 (IE) の早期の結果の決定因子に関するデータは限られている.
- この研究では,大規模な将来的なIEコホートにおける初期の臨床特徴の予後的重要性を評価しました.
研究 の 目的:
- 感染症性内心炎患者における入院死亡率の早期臨床予測要因を特定する.
- IEにおける早期エコーカルディオグラフィの発見の予後的価値を評価する.
主な方法:
- 修正されたデューク基準による確固たる/可能なIEを有する267人の患者の見通し評価.
- APACHE IIスコアとフレミングハム基準による早期心不全を用いた急性生理学的評価.
- 死亡の独立した予測要因を決定するためのロジスティック回帰モデリング.
主要な成果:
- 病院での死亡率は19%でした.
- 死亡の独立した予測要因には,糖尿病,Staphylococcus aureus感染,APACHE IIスコア,および栓塞性イベントが含まれていました.
- 初期のエコーカルディオグラフィの発見は,死亡率を予測できませんでした.
結論:
- 宿主-病原体相互作用を反映した容易に入手可能な臨床的特徴は,IEにおける入院死亡を予測します.
- これらの要因は,より積極的な治療戦略から恩恵を受ける可能性のあるIE患者を特定することができます.
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