心脏植入式电子设备和血液感染:管理和结果
Tardu Özkartal1, Andrea Demarchi1, Giulio Conte1,2
1Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete 48, Lugano 6900, Switzerland.
患有心脏植入式电子设备 (CIED) 的患者的血流感染 (BSI) 往往被诊断和治疗不充分,尤其是在非心脏病学单位入院时. 这导致死亡风险显著上升,突显了改善诊断和跨学科方法的必要性.
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:
- 血流感染 (BSI) 对心脏植入式电子设备 (CIED) 患者构成风险.
- 在CIED接受者中,设备感染可能由任何原因的BSI引起.
研究的目的:
- 调查患者的诊断方法,治疗和结果与植入式心脏转移器除器 (ICDs) 和心脏再同步治疗除器 (CRT-Ds) 住院治疗BSI.
- 了解在这种患者群体中诊断和管理BSI的挑战.
主要方法:
- 在2012年至2021年间植入ICD/CRT-D患者的单中心,回顾性队列分析.
- 在住院期间,患者被选为阳性血液培养.
- 收集和分析了BSI情节,治疗和结果的数据.
主要成果:
- 在515名患者中,36名患者经历了47次BSI发作,平均随访时间为59个月.
- 大多数BSI患者 (92%) 被录入非心脏病科,其中53%缺乏心脏成像.
- 患有BSI的患者有近七倍的全因死亡风险 (HR 6.7).
结论:
- 对于患有BSI的除器患者的诊断工作,特别是在非心脏病学部门,对于与有关的内心炎,往往是不够的.
- 高死亡率可能源于低诊断和延迟/缺席的系统切除.
- 加强跨学科合作和更多地使用心脏成像对于及时诊断和有效治疗至关重要.
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