Capilla E, Poyet R, Tortat A-V, Marchi J, Brocq F-X, Pons F, Kerebel S, Jego C, Mayet A, Cellarier G R
Service de cardiologie, hôpital Sainte-Anne, BCRM, boulevard Sainte-Anne, BP 600, 83800 Toulon cedex 9, France.
Service épidémiologique et recherche clinique, centre d'épidémiologie et de santé publique des armées (CESPA), GSBdD de Marseille Aubagne, 111, avenue de la Corse, BP 40026, 13568 Marseille cedex 02, France.
Ann Cardiol Angeiol (Paris). 2017 Apr;66(2):87-91. doi: 10.1016/j.ancard.2016.09.042. Epub 2017 Jan 13.
Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a severe disease. The aim of the study was to describe clinical features and prognosis of patients with IE in a non-teaching hospital and compare them with current data and a similar study conducted 10 years earlier in the same center.
We performed a single institution retrospective study including all patients with Duke-Li definite IE between 2004 and 2014.
Ninety-four patients were included. Results are consistent with current French and international data, including in-hospital death rate of 16%. In accordance with literature, we report on an increase in Staphylococcus and health care-associated IE and endocarditis on pacemaker leads, but without significant difference compared to our previous study. In univariate analyses, renal failure, age over 77 years and Staphylococcus aureus IE were associated with in-hospital mortality. In multivariate analyses, predictors of in-hospital death were renal failure and lack of surgery. There was a non-significant trend of excess mortality in Staphylococcus endocarditis and in patients with heart failure.
IE remains a severe disease and S. aureus is more often involved. IE seems to be safely managed in a peripheral hospital provided that there is a partnership with a reference hospital.
尽管在诊断和治疗方面取得了进展，但感染性心内膜炎（IE）仍然是一种严重的疾病。本研究的目的是描述一家非教学医院中IE患者的临床特征和预后，并将其与当前数据以及10年前在同一中心进行的类似研究的数据进行比较。
我们进行了一项单机构回顾性研究，纳入了2004年至2014年间所有符合杜克-李标准确诊的IE患者。
共纳入94例患者。结果与当前法国和国际数据一致，包括住院死亡率为16%。与文献一致，我们报告了葡萄球菌感染、医疗保健相关IE以及起搏器导线感染性心内膜炎的增加，但与我们之前的研究相比无显著差异。在单因素分析中，肾衰竭、77岁以上年龄和金黄色葡萄球菌IE与住院死亡率相关。在多因素分析中，住院死亡的预测因素是肾衰竭和未进行手术。葡萄球菌性心内膜炎患者和心力衰竭患者的死亡率有增加的趋势，但无统计学意义。
IE仍然是一种严重的疾病，金黄色葡萄球菌感染更为常见。如果与参考医院建立合作关系，外周医院似乎可以安全地管理IE。
