重复使用药物和重复手术为急性传染性内心炎的门手术
Hakam Rajjoub1, Stanley Wolfe1, Luigi F Lagazzi1
1Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
JTCVS open
|July 9, 2025
概括
感染性内心炎的复手性门手术具有很高的风险. 虽然药物使用障碍 (SUD) 患者的初始重复手术没有显示增加伤害,但多次重复手术显著增加了发病率和死亡率.
科学领域:
- 心血管外科心血管外科
- 传染病 传染病 传染病
- 成 药物 药物 药物 药物
背景情况:
- 针对传染性内心炎 (REDO) 的复手性门手术与显著的发病率和死亡率有关.
- 药物使用障碍 (SUD) 在管理复发性传染性内心炎和随后的手术决定方面提出了独特的挑战.
研究的目的:
- 评估复发性物质使用对感染性内心炎复手性门手术后结果的影响.
- 评估重新手术和物质使用障碍之间的相互作用,在因内心炎进行门手术的患者中.
主要方法:
- 对机构内心炎数据库 (2016年7月至2024年6月) 的分析,包括胸腔外科医生协会 (STS) 的数据.
- 741名患者的分层,按再手术状态和SUD的存在进行分层.
- 多变量回归建模用于评估风险调整后的结果.
主要成果:
- 与首次手术相比,复手性门手术 (REDO) 与较高的死亡率和主要发病率有关.
- 在没有SUD的患者中,REDO增加了死亡率/发病率 (OR 4.6).
- 在SUD患者中,最初的REDO没有显著影响结果 (OR 1.4),但>2次重复手术与风险调整后较高的重大发病率/死亡率 (OR 6.23) 有关.
结论:
- 感染性内心炎的重新手术增加了不良结果.
- 对于SUD患者来说,风险主要与多次重复手术有关,不一定是最初的重复手术.
- 结果可以指导临床决策对于SUD患者的复发性内心炎.
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