活跃心内膜炎的手术治疗COVID-19大流行前后的开始
Elisa Mikus1, Mariafrancesca Fiorentino1, Diego Sangiorgi1
1Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy.
Biomedicines
|January 26, 2024
概括
传染性内心炎 (IE) 手术在COVID-19后增加,其中关病例更多. 尽管流行病延迟,但患者的结果和死亡率在很大程度上不受COVID-19的影响.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 感染性内心炎 (IE) 尽管有先进的医疗护理,但仍存在重大风险.
- COVID-19大流行对IE诊断和手术结果的影响仍然不清楚.
- 这项研究调查了COVID-19大流行前后手术治疗IE的变化.
研究的目的:
- 分析手术治疗IE的发生率和特征.
- 为了比较患者在COVID-19大流行之前和之后的IE手术结果.
- 评估COVID-19对IE手术管理的影响.
主要方法:
- 对535名因IE而接受门手术的患者 (2010-2022) 的回顾性分析.
- 患者分为COVID-19前 (n=393) 和COVID-19后 (n=142) 的两组.
- 使用了治疗权重的逆概率 (IPTW) 和中断时间序列分析 (ITSA).
主要成果:
- 在COVID-19后的队列中,共患病 (糖尿病,高血压,需要透析的损伤) 增加.
- 与金黄色葡萄球菌相关的IE患病率增加,转向了对心心膜的感染.
- 早期死亡率,1年死亡率和复发率在各组之间相似;手术前功能障碍是死亡率的关键预测因素.
结论:
- 经过手术治疗的IE发病率在流行后上升,其中关的比例更高.
- 尽管COVID-19期间可能出现手术时间延迟,但死亡率和整体结果没有显著影响.
- 需要透析的术前功能障碍是IE手术中早期死亡的关键风险因素.
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