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土耳其一家三级护理中心的感染性心内膜炎的特征、流行病学特征和临床结局的危险因素。

Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey.

机构信息

Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital , Istanbul , Turkey.

出版信息

Infect Dis (Lond). 2019 Oct;51(10):738-744. doi: 10.1080/23744235.2019.1646431. Epub 2019 Jul 31.

Abstract

We aimed to investigate the clinical, laboratory, microbiological characteristics of IE in a single tertiary care centre in Turkey and to identify the factors associated with in-hospital mortality. A total of 155 consecutive adult patients (≥18 years) admitted to our single tertiary care hospital between 2009 and 2019 with definite infective endocarditis were retrospectively included in the study. The mean age of the patients was 58 years. Among 155 endocarditis episodes, 60% involved prosthetic valves, 35.5% had native valve endocarditis (NVE) and 4.5% were device related. Prosthetic valve disease was the most frequent predisposing valve lesion followed by degenerative valvular disease. Vegetations were detected in 103 (66.5%) patients by transthoracic echocardiography and in 145 (93%) patients by transoesophageal echocardiography. The most commonly affected valve was the mitral valve in 84 (54.2%) patients, followed by 67 (43.2%) aortic valve. were the most frequent causative microorganisms isolated in both NVE (31.8%), prosthetic valve endocarditis (38.9%) and device related IE cases. At least one complication was present in 70 patients (45.2%). One hundred and eight patients underwent surgical therapy (69.7%). Age, syncope, heart failure, perforation, septic shock, renal failure, high red cell distribution width, atrial fibrillation, hypocalcaemia, pulmonary hypertension were associated with high mortality. We identified a 10-year presentation of IE in a referral centre in Turkey. Likely other series, we observed more endocarditis with the aging of the population. Surgery was associated with higher in-hospital survival. Age, syncope, perforation, septic shock were independent predictors of mortality.

摘要

我们旨在研究土耳其一家三级保健中心的感染性心内膜炎(IE)的临床、实验室和微生物学特征,并确定与院内死亡率相关的因素。 共有 155 名连续的成年患者(≥18 岁)于 2009 年至 2019 年期间因明确的感染性心内膜炎入住我院三级保健中心,回顾性纳入本研究。 患者的平均年龄为 58 岁。 在 155 例心内膜炎发作中,60%涉及人工瓣膜,35.5%为原发性心内膜炎(NVE),4.5%与器械相关。 人工瓣膜疾病是最常见的易患瓣膜病变,其次是退行性瓣膜疾病。 经胸超声心动图检测到 103 例(66.5%)患者有赘生物,经食管超声心动图检测到 145 例(93%)患者有赘生物。 最常受累的瓣膜是二尖瓣,共 84 例(54.2%),其次是主动脉瓣 67 例(43.2%)。 在 NVE(31.8%)、人工瓣膜心内膜炎(38.9%)和器械相关 IE 病例中,最常见的病原体分离株是链球菌。 70 例(45.2%)至少有一个并发症。 108 例患者接受了手术治疗(69.7%)。 年龄、晕厥、心力衰竭、穿孔、感染性休克、肾衰竭、高红细胞分布宽度、心房颤动、低钙血症、肺动脉高压与高死亡率相关。 我们确定了土耳其一家转诊中心 10 年来 IE 的表现。 与其他系列一样,我们观察到更多的随着人口老龄化而发生的心内膜炎。 手术与较高的院内生存率相关。 年龄、晕厥、穿孔、感染性休克是死亡率的独立预测因素。

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