Saleem Ben R, Meerwaldt Robbert, Tielliu Ignace F J, Verhoeven Eric L G, van den Dungen Jan J A M, Zeebregts Clark J
Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Am J Surg. 2010 Jul;200(1):47-52. doi: 10.1016/j.amjsurg.2009.05.018. Epub 2010 Jan 15.
The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections.
Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with central prosthetic graft infections. Univariate and multivariate analyses were performed to define factors predictive of mortality.
Thirty-three men and 11 women (mean age, 71 years) were included. There was considerable comorbidity. Coagulase-negative Staphylococcus and S aureus were isolated in almost 50% of the patients. The mean follow-up duration was 5 years, during which 20 patients (46%) died. The main causes of death were related to vascular disease. Conservative treatment with antibiotics was the only variable with significant predictive value on multivariate analysis (hazard ratio, 3.62; 95% confidence interval, 1.17-11.24; P = .02).
Conservative treatment of prosthetic graft infections was associated with high mortality; therefore, it should be limited to a specific group. Patients who are not capable of undergoing open repair may benefit from conservative management. Otherwise, aggressive open treatment seems indicated.
本研究旨在确定影响血管人工血管移植物感染患者预后的患者相关因素和/或疾病相关因素。
通过医院患者管理系统，在1997年1月至2007年12月期间，共有44例患者被诊断为中心性人工血管移植物感染。进行单因素和多因素分析以确定预测死亡率的因素。
纳入33例男性和11例女性（平均年龄71岁）。存在相当多的合并症。近50%的患者分离出凝固酶阴性葡萄球菌和金黄色葡萄球菌。平均随访时间为5年，在此期间20例患者（46%）死亡。主要死亡原因与血管疾病有关。多因素分析显示，仅抗生素保守治疗具有显著的预测价值（风险比，3.62；95%置信区间，1.17 - 11.24；P = 0.02）。
人工血管移植物感染的保守治疗与高死亡率相关；因此，应仅限于特定人群。无法进行开放修复的患者可能从保守治疗中获益。否则，积极的开放治疗似乎是必要的。
