成人的左侧原生膜内心炎复杂:死亡率的风险分类
Rodrigo Hasbun1, Holenarasipur R Vikram, Lydia A Barakat
1Infectious Disease Section, Tulane University School of Medicine, New Orleans, La, USA.
JAMA
|April 17, 2003
概括
一个新的预后系统准确地将患有复杂左侧原生膜内心炎的成年人分为四组的风险分层. 这种工具有助于管理患有这种严重疾病的患者,改善结果.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 临床预后 临床预后
背景情况:
- 复杂的左侧原生膜内心炎由于高发病率和死亡率而构成重大挑战.
- 缺乏验证的预后数据使临床管理策略复杂化.
研究的目的:
- 开发和外部验证诊断成年患者的预后分类系统,诊断出复杂的左侧本源内心炎.
主要方法:
- 一项回顾性观察队列研究涉及513名成年患者,从1990年至2000年间在7家医院接受治疗.
- 患者被分为导出 (n=259) 和验证 (n=254) 队列.
- 主要结局指标是从基线后6个月的所有原因死亡率.
主要成果:
- 六个月死亡率为25% (衍生) 和26% (验证).
- 确定了五个独立的死亡预测因素:并发症,精神状况异常,充血性心力衰竭,特定的细菌病因和非手术医疗管理.
- 导出的预后系统将患者分为四个风险组,其6个月死亡率在导出队列中为5%至59%,在验证队列中为7%至69%.
结论:
- 使用基线特征的经过验证的预后分类系统可以准确地分层患有复杂左侧本源内心炎的成年人.
- 该系统为指导临床管理决策和改善患者治疗结果提供了宝贵的工具.
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