膜手术与患有由心力衰竭复杂的传染性内心炎的患者死亡率之间的关联
Todd Kiefer1, Lawrence Park, Christophe Tribouilloy
1Duke University Medical Center, Durham, NC 27710, USA.
JAMA
|November 24, 2011
概括
心力衰竭 (HF) 是传染性内心炎的常见并发症. 感染性内心炎和HF患者的膜手术显著降低了住院和1年死亡率.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 心脏外科手术 心脏外科手术
背景情况:
- 心力衰竭 (HF) 是感染性内心炎 (IE) 最常见的并发症.
- 临床特征,手术治疗和IE患者中HF的结果尚未确定.
- 了解这些因素对于改善患者管理至关重要.
研究的目的:
- 为了确定与IE患者中HF相关的临床,心声和微生物学因素.
- 为了评估与医院住院和1年死亡率相关的变量,在IE患者HF.
- 评估手术治疗对结果的影响.
主要方法:
- 分析来自国际协作内心炎前性队列研究的数据.
- 包括4075名患有确定的感染性内心炎和已知的HF状态的患者.
- 检查住院和1年死亡率.
主要成果:
- 在33.4%的IE患者中存在HF,其中66.7%出现严重症状 (NYHA类III/IV).
- 在住院期间,在61.7%的HF患者中进行了膜手术.
- 手术与医院住院 (20.6%与44.8%) 和1年 (29.1%与58.4%) 的死亡率明显较低有关.
结论:
- 在IE中HF的严重程度与手术干预和死亡率密切相关.
- 在IE患者中进行的膜手术改善了HF的生存率.
- 年龄,并发症,感染类型和并发症等因素独立预测死亡率.
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