活动性感染性心内膜炎的早期结果。
Early results for active infective endocarditis.
作者信息
Aithoussa Mahdi, Atmani Noureddine, Mounir Reda, Moutakiallah Younes, Bamous Mehdi, Abdou Abdessamad, Nya Fouad, Seghrouchni Anis, Bellouize Siham, Drissi Mohamed, Elouennass Mostafa, Elbekkali Youssef, Boulahya Abdelatif
机构信息
Department of Cardiovascular Surgery, Mohammed V Teaching Military Hospital, Hay Riad, 10100 Rabat, Morocco.
Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Souissi, Madinat Al Irfane, 10100 Rabat, Moroc.
出版信息
Pan Afr Med J. 2017 Nov 21;28:245. doi: 10.11604/pamj.2017.28.245.13518. eCollection 2017.
INTRODUCTION
Cardiac surgery is frequently needed during active phase of infective endocarditis (IE). The purpose of this study was to analyze the immediate and late results and determine the risk factors for death.
METHODS
We retrospectively reviewed 101 patients with IE operated in the active phase. The mean age was 40.5 ± 12.5 years. 16 patients (15.8%) were diagnosed with prosthetic valve endocarditis (PVE). 81 (80.9%) were in NYHA functional class III-IV. Blood cultures were positive in only 24 cases (23.9%).
RESULTS
in-hospital mortality rate was 17.9% (18 cases). Multivariate analysis indentified five determinant predictor factors: congestive heart failure (CHF), renal insufficiency, high Euroscore, prolonged cardiopulmonary bypass time (> 120 min) and long ICU stay. The median follow-up period was 4.2 (2-6.5) years. Overall survival rate for all patients who survived surgery was 97% at 5 years and 91% at 10 years.
CONCLUSION
Despite high in-hospital mortality rate, when patients receive operation early in the active phase of their illness, late outcome may be good.
引言
感染性心内膜炎（IE）活动期常需进行心脏手术。本研究旨在分析近期和远期结果，并确定死亡的危险因素。
方法
我们回顾性分析了101例在活动期接受手术的IE患者。平均年龄为40.5±12.5岁。16例（15.8%）诊断为人工瓣膜心内膜炎（PVE）。81例（80.9%）为纽约心脏协会（NYHA）心功能Ⅲ-Ⅳ级。仅24例（23.9%）血培养呈阳性。
结果
住院死亡率为17.9%（18例）。多因素分析确定了五个决定性预测因素：充血性心力衰竭（CHF）、肾功能不全、欧洲心脏手术风险评估系统（Euroscore）评分高、体外循环时间延长（>120分钟）和重症监护病房（ICU）停留时间长。中位随访期为4.2（2-6.5）年。所有术后存活患者的5年总生存率为97%，10年为91%。
结论
尽管住院死亡率高，但如果患者在疾病活动期早期接受手术，远期结果可能良好。
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