左侧传染性内心炎手术后长期死亡率的预后因素
Se Ju Lee1,2, Jung Ho Kim1, Yongseop Lee1
1Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
PloS one
|March 31, 2025
概括
中枢神经系统并发症,慢性肝病和年龄较大增加左侧感染性内心炎 (LSIE) 患者在手术后的死亡风险. 对中枢神经系统并发症的预防策略对于改善LSIE治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 外科手术的结果
背景情况:
- 传染性内心炎 (IE) 的死亡率很高,左侧IE (LSIE) 比右侧IE更致命.
- 有时用于LSIE的手术干预,但长期预后因素仍未得到充分研究.
- 这项研究旨在确定手术治疗LSIE患者长期死亡率的预测因素.
研究的目的:
- 调查因左侧传染性内心炎进行手术治疗的患者与长期死亡相关的风险因素.
- 为改善LSIE患者的管理和结果提供见解.
主要方法:
- 对239名LSIE成年患者进行了回顾性研究,这些患者在Severance医院接受了手术 (2005年11月 - 2017年8月).
- 总体而言,全因死亡率是主要结局.
- 用多变量考克斯回归分析来确定长期死亡的独立风险因素.
主要成果:
- 随访时间中位数为75.9个月,34例死亡 (14.2%).
- 死亡的独立风险因素包括中枢神经系统 (CNS) 并发症 (HR:3.55),慢性肝病 (CLD) (HR:4.33) 和65岁以上的年龄 (HR:2.65).
- 卡普兰-梅尔分析证实,中枢神经系统并发症患者的生存率明显降低 (P < 0.001).
结论:
- 中枢神经系统并发症,慢性肝病和晚年 (≥65岁) 是手术治疗LSIE患者长期死亡的重要风险因素.
- 开发中枢神经系统并发症的预防策略可以大大改善LSIE的治疗结果.
- 这些发现突出了临床重点在管理高风险LSIE人群的关键领域.
相关概念视频
Factors Affecting the Risk of Infection
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 create...
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 create...
Endocarditis I: Introduction
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...
Endocarditis III: Medical Management
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...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...


