在感染性内心炎中,手术前中风的时间与大小的相对重要性
Brittany A Zwischenberger1, Akosua Odei1, Christopher Jensen1
1Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham NC, USA.
The Annals of thoracic surgery
|August 29, 2025
概括
在感染性内心炎手术中,无论手术时间如何,手术前的大型中风都会增加术后中风的风险. 建议在患有左侧传染性内心炎和手术前小型中风的患者进行早期干预.
科学领域:
- 心脏病学
- 神经外科
- 传染性疾病
背景情况:
- 在手术前中风的感染性内心炎 (IE) 中进行手术的最佳时间尚不清楚.
- 脑电阻会影响心脏门,而中风则可能是并发症.
研究的目的:
- 确定手术前中风特征与术后中风的时间之间的关联.
- 为了指导有中风病史的IE患者的手术决策.
主要方法:
- 针对急性IE进行门手术的成年患者的回顾研究 (1991-2023年).
- 术前大脑中风的定义:脑中风体积>= 20厘米3通过MRI.
- 多变量逻辑回归分析以确定术后中风的危险因素.
主要成果:
- 21% 的IE患者患有手术前的中风;大多数是小的和缺血性.
- 在所有患者中,术后中风发生率为4. 3%,而在术前中风患者中发生率更高 (6. 9% vs 3. 7%).
- 在手术前的大型中风显著增加了术后中风的风险 (22%与4%相比),而这与中风到手术的时间无关.
结论:
- 在IE中,中风的大小与术后中风有显著的关联,而不是手术的时间.
- 应考虑对左侧IE患者进行早期干预.
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