跨导管大动脉置换与随后感染性内心炎和住院死亡之间的关联
Ander Regueiro1, Axel Linke2, Azeem Latib3
1Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
JAMA
|September 14, 2016
概括
通过导管更换大动脉 (TAVR) 后的传染性内心炎与年轻年龄,男性性别,糖尿病和大动脉吐有关. 患者在TAVR相关内心炎后面临高住院和2年死亡率.
科学领域:
- 心脏病学
- 传染性疾病
- 医疗器械
背景情况:
- 通过导管切换主动脉 (TAVR) 发生感染性内心炎的患者的临床特征和结果的数据有限.
- 了解这些因素对于改善TAVR程序后的患者管理和结果至关重要.
研究的目的:
- 确定与TAVR发生感染性内心炎的患者相关的因素,临床特征和结果.
- 在TAVR群体中确定感染性内心炎和相关死亡率的风险因素.
主要方法:
- 在TAVR国际注册后感染性内心炎收集了来自全球47个中心的确诊感染性内心炎患者的数据.
- 在2005年6月至2015年10月期间收集数据,重点关注发病率,危险因素,致病微生物和死亡率.
主要成果:
- 在TAVR后感染性内心炎的发病率为每人/ 年1.1%. 年龄较小,男性性别,糖尿病和中度至重度的大动脉吐与风险增加有关.
- 最常见的病原体是肠球菌和金黄色葡萄球菌. 住院死亡率为36%,两年死亡率达到66. 7%.
- 与住院死亡率相关的因素包括更高的后勤EuroSCORE,心力衰竭和急性损伤.
结论:
- 年龄较小,男性性别,糖尿病和残留主动脉吐是TAVR后感染性内心炎的重要危险因素.
- 在TAVR之后的传染性内心炎与大量的住院和长期死亡率有关,这凸显了需要谨慎监测和管理的必要性.
相关概念视频
Endocarditis I: Introduction
666
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
666
Endocarditis III: Medical Management
302
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
302
Endocarditis II: Clinical Features of Infective Endocarditis
687
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
687
Endocarditis IV: Nursing Management
522
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
522
Factors Affecting the Risk of Infection
14.5K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
14.5K
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
6.4K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
6.4K


