与心脏器件相关的传染性内心炎患者的死亡率的预测因素
Gustavo Brandão Oliveira1, Isabela Galizzi Fae1, Vinícius Tostes Carvalho2
1Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte 30130-100, MG, Brazil.
Tropical medicine and infectious disease
|September 27, 2024
概括
心脏器件相关内心炎 (CDIE) 是一种严重的感染,死亡率高. 这项研究确定了C反应蛋白 (CRP) 水平和恶化的心力衰竭作为CDIE患者住院死亡的预测因素.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 生物医学工程 生物医学工程
背景情况:
- 与可植入心脏器件 (ICD) 相关的传染性内心炎 (IE) 是一个重大的临床挑战,死亡率高.
- ICD植入物越来越普遍与与设备相关的感染的增加相关,需要更深入地了解与心脏设备相关的内心炎 (CDIE).
研究的目的:
- 描述诊断为CDIE的患者的临床和实验室概况.
- 确定CDIE患者住院死亡率的预测因素.
- 为了评估CDIE的预后,与原生膜内心炎相比,挑战传统假设的更好的结果.
主要方法:
- 一项前性队列研究包括2007年至2019年间的274名IE患者.
- 有82名患者 (30%) 确诊患有CDIE,其中包括起器,心脏转换器-除器和心脏再同步治疗设备.
- 收集的数据包括临床,实验室,心声学参数,病因因子和住院结果.
主要成果:
- CDIE患者的平均年龄为55.8岁,64.6%是男性.
- 常见的临床表现包括心力衰竭 (67.9%),发烧 (60.5%) 和厌食症 (44.4%).
- 中位数的C反应蛋白 (CRP) 水平为63 mg/L. 阴性凝结体葡萄球菌和金黄色葡萄球菌是主要的致病因子.
- 在90.1%的患者中检测到植被.
- 住院死亡率达到了28%. 升高的CRP度和恶化的心力衰竭是住院死亡的重要预测因素.
结论:
- CDIE与显著的发病率和死亡率有关,其中很大一部分患者患有心力衰竭.
- 诊断时的血清CRP水平作为CDIE疾病严重程度的标志物.
- 与以前的看法相反,CDIE似乎没有比其他形式的传染性内心炎更好的预后.
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