Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Cardiac Imaging Centre, Toulouse University Hospital, 31400 Toulouse, France; Department of Nuclear Medicine, Rangueil University Hospital, 31059 Toulouse, France; Heart Valve Centre, Toulouse University Hospital, 31400 Toulouse, France.
Department of Cardiology, Taaone Hospital Centre, 98714 Papeete, Tahiti, France.
Arch Cardiovasc Dis. 2020 Apr;113(4):252-262. doi: 10.1016/j.acvd.2019.12.007. Epub 2020 Feb 15.
French Polynesia is a French overseas collectivity in the South Pacific Ocean, where data on infective endocarditis (IE) are lacking.
To investigate the epidemiology and outcomes of IE in French Polynesia.
All hospital records from consecutive patients hospitalized in Taaone Hospital, Tahiti, from 2015 to 2018, with an International Classification of Diseases, 10th revision, separation diagnosis of IE (I330), were reviewed retrospectively.
From 190 hospital charts reviewed, 105 patients with a final diagnosis of IE, confirmed according to the modified Duke criteria, were included. The median duration of follow-up was 71 days (interquartile range 18-163 days). The mean age was 55±17 years, and there were 68 men (65%). Thirty-five patients (33%) had a history of rheumatic carditis and 43 (41%) had a prosthetic valve. There were 40 (38%) cases of staphylococcal IE, 32 (30%) of streptococcal IE and six (6%) of enterococcal IE. Cardiogenic shock, septic shock and clinically relevant cerebral complications were strongly associated with death from any cause (hazard ratio [HR] 16.85, 95% confidence interval [CI] 5.45-52.05 [P<0.001]; HR 2.62, 95% CI 1.23-5.56 [P=0.01]; and HR 4.14, 95% CI 1.92-8.92 [P<0.001], respectively). Seventy-three patients (69%) had a theoretical indication for surgery, which was performed in 38 patients (36%). Lack of surgery when there was a theoretical indication was significantly associated with death (HR 6.93, 95% CI 3.47-13.83; P<0.0001).
The pattern of IE in French Polynesia differs from Western countries in many ways. Postrheumatic valvular disease remains the main underlying disease, and access to emergency heart surgery is still a challenge.
法属波利尼西亚是南太平洋的一个法国海外集体，缺乏有关感染性心内膜炎（IE）的数据。
调查法属波利尼西亚 IE 的流行病学和结局。
回顾性分析了 2015 年至 2018 年塔希提岛 Taone 医院连续住院的患者的所有病历，这些患者的国际疾病分类，第 10 版，分离诊断为 IE（I330）。
从 190 份病历中，有 105 例最终诊断为 IE 的患者，根据改良的 Duke 标准得到确认。中位随访时间为 71 天（四分位距 18-163 天）。平均年龄为 55±17 岁，有 68 名男性（65%）。35 例（33%）有风湿性心内膜炎病史，43 例（41%）有假体瓣膜。40 例（38%）为葡萄球菌性 IE，32 例（30%）为链球菌性 IE，6 例（6%）为肠球菌性 IE。心源性休克、脓毒性休克和临床相关的脑并发症与任何原因导致的死亡密切相关（危险比[HR]16.85，95%置信区间[CI]5.45-52.05[P<0.001]；HR 2.62，95%CI 1.23-5.56[P=0.01]；HR 4.14，95%CI 1.92-8.92[P<0.001]）。73 例（69%）患者有手术的理论适应证，但仅对 38 例（36%）患者进行了手术。当有理论适应证时未行手术与死亡显著相关（HR 6.93，95%CI 3.47-13.83；P<0.0001）。
法属波利尼西亚的 IE 模式在许多方面与西方国家不同。风湿性瓣膜病仍是主要的潜在疾病，紧急心脏手术的机会仍然是一个挑战。
