对心室辅助器件感染的前性多中心研究
Rachel J Gordon1, Alan D Weinberg, Francis D Pagani
1Departments of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. rj216@columbia.edu
Circulation
|January 15, 2013
概括
心室辅助装置 (VAD) 感染很常见,特别是在传动线上,并增加死亡率. 抑郁症和功能障碍是VAD感染的关键风险因素.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗器械 医疗器械
背景情况:
- 心室辅助器件 (VADs) 提高了晚期心力衰竭的存活率,但容易感染.
- 关于VAD相关感染的微生物学和流行病学数据有限.
- 这项研究解决了VAD感染流行病学的知识差距.
研究的目的:
- 调查VAD相关感染的发病率,微生物学和风险因素.
- 确定VAD感染的预测因素及其对患者结果的影响.
- 评估较新的VAD设备在感染率中的作用.
主要方法:
- 预期的,多中心招募150名接受VAD植入的患者 (2006-2008).
- 随访1年或直到移植,康复或死亡.
- 收集有关感染风险因素,临床,实验室和微生物学数据的数据.
主要成果:
- 22%的患者患有VAD感染 (33名患者中有34例感染),发病率为0.10/100人/天.
- 驱动线感染最常见 (n=28),其中64%涉及侵入性疾病.
- 葡萄球菌 (47%) 和阴性细菌 (32%) 是主要的病原体;抑郁和肌氨酸升高预测了感染.
- VAD感染显著增加了1年死亡率 (aHR=5.6).
结论:
- 感染仍然是VAD植入的常见并发症,即使是使用较新的设备.
- 患有抑郁症和功能障碍等患者因素是VAD感染的重要危险因素.
- VAD感染对患者的生存构成严重威胁,需要谨慎管理.
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