Zhang Wei, Ju Ping, Liu Xuemei, Zhou Haiyan, Xue Feng
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Nursing, Qingdao Fifth People's Hospital (Shandong Qingdao Hospital of Integrated Traditional and Western Medicine), Qingdao, China.
J Int Med Res. 2020 Jul;48(7):300060520940435. doi: 10.1177/0300060520940435.
To clarify differences in clinical characteristics and outcomes between patients with infective endocarditis (IE) receiving long-term haemodialysis (HD group) and those not receiving haemodialysis (non-HD group).
Medical records of patients with IE, admitted to hospital between January 2010 and December 2017, were retrospectively studied. Clinical characteristics and outcomes were compared between HD and non-HD groups. Risk factors for IE were assessed by COX regression.
Twenty-one HD and 143 non-HD patients were included. Predisposing heart conditions were more frequently observed in the non-HD versus HD group (90.9% versus 19.0%). Inappropriate antibiotic therapy rate before admission and proportion of methicillin-resistant and -associated IE was higher in the HD versus non-HD group. In the HD group, fewer patients underwent heart surgery (9.5% versus 51.7%), all-cause in-hospital mortality was higher (52.4% versus 21%), and survival rate was lower versus the non-HD group. COX regression analysis revealed that haemodialysis, use of central venous catheter (CVC) and inappropriate antibiotic therapy before admission increased IE mortality, while surgery improved long-term prognosis.
Haemodialysis patients with IE may have higher mortality and lower survival rates than patients with IE not receiving haemodialysis. Haemodialysis, use of CVC and inappropriate antibiotic therapy before admission may increase IE mortality. Surgery may improve long-term prognosis.
阐明接受长期血液透析的感染性心内膜炎（IE）患者（血液透析组）与未接受血液透析的患者（非血液透析组）在临床特征和预后方面的差异。
回顾性研究2010年1月至2017年12月期间入院的IE患者的病历。比较血液透析组和非血液透析组的临床特征和预后。通过COX回归评估IE的危险因素。
纳入21例血液透析患者和143例非血液透析患者。非血液透析组比血液透析组更常观察到易患心脏病（90.9%对19.0%）。血液透析组入院前不适当抗生素治疗率以及耐甲氧西林和相关IE的比例高于非血液透析组。在血液透析组中，接受心脏手术的患者较少（9.5%对51.7%），全因住院死亡率较高（52.4%对21%），与非血液透析组相比生存率较低。COX回归分析显示，血液透析、使用中心静脉导管（CVC）和入院前不适当抗生素治疗会增加IE死亡率，而手术可改善长期预后。
与未接受血液透析的IE患者相比，接受血液透析的IE患者可能具有更高的死亡率和更低的生存率。血液透析、使用CVC和入院前不适当抗生素治疗可能会增加IE死亡率。手术可能会改善长期预后。
