Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
Int J Infect Dis. 2013 Jun;17(6):e391-3. doi: 10.1016/j.ijid.2012.12.009. Epub 2013 Jan 23.
We noted only rare reports of cirrhotic patients with bacterial endocarditis (BE). There is insufficient data on the risk of BE in liver cirrhosis. This is the first national population-based study evaluating the risk of BE in cirrhotic patients.
We used the National Health Insurance Database, which is derived from the Taiwan National Health Insurance Program. The study cohort comprised 40803 patients with cirrhosis and the comparison cohort consisted of 40841 randomly selected subjects with a similar age and sex distribution.
Of the total 81644 patients, 192 (0.24%) experienced BE during the 3-year follow-up period, 121 patients from the study cohort (0.30% of the cirrhotic patients) and 71 patients from the comparison group (0.17% of non-cirrhotic patients) (p<0.001). After adjusting for patient age, sex, and comorbid disorders, the Cox regression analysis showed that cirrhotic patients had a high risk of BE compared to non-cirrhotic patients during the 3-year follow-up period (hazard ratio 2.04, 95% confidence interval 1.61-2.44, p<0.001).
We conclude that liver cirrhosis is a risk factor for the occurrence of BE.
我们仅注意到少数肝硬化患者发生细菌性心内膜炎(BE)的报告。关于肝硬化患者发生 BE 的风险的数据不足。这是第一项评估肝硬化患者发生 BE 风险的全国性基于人群的研究。
我们使用了来源于台湾全民健康保险计划的国民健康保险数据库。研究队列包括 40803 例肝硬化患者,对照组由 40841 名年龄和性别分布相似的随机选择的受试者组成。
在总计 81644 例患者中,有 192 例(0.24%)在 3 年随访期间发生 BE,其中 121 例来自研究队列(肝硬化患者的 0.30%),71 例来自对照组(非肝硬化患者的 0.17%)(p<0.001)。在校正了患者年龄、性别和并存疾病后,Cox 回归分析显示,在 3 年随访期间,肝硬化患者发生 BE 的风险高于非肝硬化患者(危险比 2.04,95%置信区间 1.61-2.44,p<0.001)。
我们的结论是,肝硬化是发生 BE 的一个危险因素。