左心室辅助器件接受者的淋巴病:发生率,危险因素和结果
Rebecca Anderson1, Stephanie Pouch2, Lindsay Busch2
1Emory University School of Medicine, Atlanta, Georgia, USA.
Open forum infectious diseases
|May 16, 2025
概括
左心室辅助器件 (LVAD) 接收者患有白血病的病例较早出现,并与较高的死亡率有关. 识别风险因素,如通风持续时间,可以指导这些患者早期的抗真菌治疗.
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:
- 在左心室辅助器件 (LVAD) 接受者中,氏菌 (Candida 血流感染 [C-BSI]) 尚不清楚.
- 这项研究调查了LVAD接受者中C-BSI的发病率,风险因素和结果.
研究的目的:
- 为了确定患有左心室辅助器件的患者候选血病的发病率,风险因素和结果.
- 使用随机森林模型识别C-BSI的关键预测因素.
主要方法:
- 从2015年1月到2024年4月,对656名成年LVAD接受者的回顾性分析.
- 18名C-BSI患者与90名LVAD接受者没有血流感染 (N-BSI) 和79名细菌血流感染 (B-BSI) 的比较.
- 利用随机森林建模用于预测因素识别和卡普兰-梅尔曲线用于生存分析.
主要成果:
- 植入后20天的中位数发生了C-BSI,并且与增加机械循环支持,脏替代疗法,全亲肠营养和长时间通风的需求有关.
- C-BSI的主要预测因素包括通风持续时间,脏替代疗法和全亲肠营养.
- 与细菌BSI相比,C-BSI导致器械内心炎的发病率更高,平均存活时间明显缩短,与细菌BSI相比.
结论:
- 在LVAD接受者中,淋巴瘤是与高死亡率相关的早期并发症.
- 鉴定的风险因素可能会为这种脆弱人群提供抗真菌预防或早期实证治疗策略.
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