Mesa Del Castillo-Payá Cristina, Rodríguez-Esteban Marcos, Quijada-Fumero Alejandro, Carballo-Arzola Leidimar, Farrais-Villalba Marcos, Afonso Ruth, Trugeda-Padilla Antonio
Servicio de Oncología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
Enferm Infecc Microbiol Clin (Engl Ed). 2018 Feb;36(2):72-77. doi: 10.1016/j.eimc.2016.10.011. Epub 2016 Dec 13.
Cancer patients may constitute a special risk group for the development of infective endocarditis (IE) because they are often subjected to invasive procedures. The aim of this study is to determine the differential clinical profile and prognosis of patients with IE and cancer.
A retrospective observational study was conducted on all patients consecutively diagnosed with IE in a single centre between 2005 and 2015. A comparative analysis was performed between patients with cancer and those free of disease, as well as a long-term follow-up.
There were 208 IE cases, of which 32 had a cancer diagnosis. There were no significant differences in age (67.5 [59.2-74] vs. 64 [51-74] years). The Charlson comorbidity index was same whether cancer was diagnosed or not (4 [2.2-5] vs. 3.9 [2-5]). IE in cancer patients was mainly associated with health care (59.5% vs 24.4%, P<.001). Staphylococcus aureus was the main causative agent (35%), and the tricuspid location was three times more common (18.8% vs. 6.2%). Surgery was not performed in 18.7% of patients, despite having an indication, compared with 7.4% of patients without cancer. In-hospital mortality for cancer patients was 45.5%, and the probability of survival at one year was 40%.
IE in patients with cancer is predominantly caused by staphylococci, and has high early mortality. Although it is often related to health care, patients are limited from the therapeutic point of view.
癌症患者可能构成感染性心内膜炎（IE）发生的特殊风险群体，因为他们经常接受侵入性操作。本研究的目的是确定IE合并癌症患者的临床特征差异及预后情况。
对2005年至2015年在单一中心连续诊断为IE的所有患者进行回顾性观察研究。对癌症患者和非癌症患者进行了比较分析，并进行了长期随访。
共有208例IE病例，其中32例有癌症诊断。年龄无显著差异（67.5[59.2 - 74]岁 vs. 64[51 - 74]岁）。无论是否诊断出癌症，Charlson合并症指数相同（4[2.2 - 5] vs. 3.9[2 - 5]）。癌症患者的IE主要与医疗保健相关（59.5% vs 24.4%，P<.001）。金黄色葡萄球菌是主要病原体（35%），三尖瓣部位更为常见（18.8% vs. 6.2%）。尽管有手术指征，但仍有18.7%的癌症患者未进行手术，而无癌症患者这一比例为7.4%。癌症患者的院内死亡率为45.5%，一年生存率为40%。
癌症患者的IE主要由葡萄球菌引起，早期死亡率高。尽管其常与医疗保健相关，但从治疗角度来看，患者受限。
