Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
J Infect Chemother. 2019 Dec;25(12):965-971. doi: 10.1016/j.jiac.2019.05.014. Epub 2019 Jul 15.
Although infectious endocarditis (IE) is a potentially severe infectious disease, there are no prognostic tools for in-hospital mortality for IE patients. This is the first report documenting that the Sequential Organ Failure Assessment (SOFA) score could evaluate the severity and outcome among IE patients.
From 2007 to 2018, we reviewed all patients who were diagnosed as having IE at our institue. Patients diagnosed as definite IE according to the modified Duke criteria or by surgical procedure were included in this study.
A total of 66 IE patients were enrolled in this study. They were 45 males (68%) and the median age was 70 years. As for prognostic factors for in-hospital death among IE patients, SOFA score ≥6, CCI ≥3, surgical procedure, heart failure, immunological phenomena and detection of S. aureus as a causative pathogen were identified as prognostic factors by univariate analysis. Of these 6 factors, SOFA score ≥6 (OR 7.6, 95%CI 1.3-46.6, p = 0.029), heart failure (OR 9.7, 95%CI 1.1-86.1, p = 0.042), surgery (OR 0.1, 95%CI 0-0.8, p = 0.037) and immunological phenomena (OR 0.1, 95%CI 0-0.9, p = 0.042) were independent prognostic factors for in-hospital mortality among IE by logistic regression analysis.
The SOFA score could be a good prognostic tool to use for IE patients. Also, SOFA score ≥6, surgery, immunological phenomena and heart failure were independent prognostic factors for in-hospital mortality among IE patients.
尽管感染性心内膜炎(IE)是一种潜在严重的传染病,但目前尚无针对 IE 患者院内死亡率的预后工具。这是第一份报告,证明序贯器官衰竭评估(SOFA)评分可用于评估 IE 患者的严重程度和结局。
从 2007 年到 2018 年,我们回顾了在我院诊断为 IE 的所有患者。根据改良的 Duke 标准或手术诊断为明确 IE 的患者纳入本研究。
本研究共纳入 66 例 IE 患者。其中男性 45 例(68%),中位年龄为 70 岁。单因素分析显示,SOFA 评分≥6、CCI≥3、手术、心力衰竭、免疫现象和金黄色葡萄球菌作为病原体与 IE 患者院内死亡的预后因素相关。在这 6 个因素中,SOFA 评分≥6(OR 7.6,95%CI 1.3-46.6,p=0.029)、心力衰竭(OR 9.7,95%CI 1.1-86.1,p=0.042)、手术(OR 0.1,95%CI 0-0.8,p=0.037)和免疫现象(OR 0.1,95%CI 0-0.9,p=0.042)是 IE 患者院内死亡率的独立预后因素。
SOFA 评分可作为 IE 患者的良好预后工具。此外,SOFA 评分≥6、手术、免疫现象和心力衰竭是 IE 患者院内死亡率的独立预后因素。