Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
BMJ Open. 2020 Sep 14;10(9):e038551. doi: 10.1136/bmjopen-2020-038551.
We aimed to describe the association between in-hospital infection and prognosis among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) who received percutaneous coronary intervention (PCI).
This observational cohort originated from a database of patients with NSTE-ACS who underwent PCI from 1 January 2010 to 31 December 2014.
Five centres in South China.
This multicentre observational cohort study consecutively included 8197 patients with NSTE-ACS who received PCI. Only patients with adequate information to diagnose or rule out infection were included. Patients were excluded if they were diagnosed with a malignant tumour, were pregnant or presented with cardiogenic shock at the index date. Patients were grouped by whether they had in-hospital infection or not.
The primary outcome was all-cause death and major bleeding during hospitalisation. The secondary outcomes included all-cause death and major bleeding during follow-up and in-hospital myocardial infarction.
Of the 5215 patients, 206 (3.95%) acquired infection. Patients with infection had a higher rate of in-hospital all-cause death and major bleeding (4.4% vs 0.2% and 16.5% vs 1.2%, respectively; p<0.001). After adjusting for confounders, infection remained independently associated with in-hospital and long-term all-cause death (OR, 13.19, 95% CI 4.59 to 37.87; HR, 2.03, 95% CI 1.52 to 2.71; p<0.001) and major bleeding (OR, 10.24, 95% CI 6.17 to 16.98; HR, 5.31, 95% CI 3.49 to 8.08; p<0.001). A subgroup analysis confirmed these results.
The incidence of infection is low during hospitalisation, but is associated with worse in-hospital and long-term outcomes.
本研究旨在描述行经皮冠状动脉介入治疗（PCI）的非 ST 段抬高型急性冠状动脉综合征（NSTE-ACS）患者住院期间感染与预后的关系。
本观察性队列研究源于 2010 年 1 月 1 日至 2014 年 12 月 31 日接受 PCI 的 NSTE-ACS 患者数据库。
中国南方的 5 个中心。
本多中心观察性队列研究连续纳入 8197 例接受 PCI 的 NSTE-ACS 患者。仅纳入有足够信息诊断或排除感染的患者。如果患者在指数日期患有恶性肿瘤、怀孕或出现心源性休克，则排除在外。根据是否发生院内感染将患者分为两组。
主要结局为住院期间全因死亡和主要出血。次要结局包括随访期间和住院期间的全因死亡和主要出血以及院内心肌梗死。
在 5215 例患者中，有 206 例（3.95%）发生感染。感染患者的院内全因死亡和主要出血发生率更高（4.4%比 0.2%和 16.5%比 1.2%；均 P<0.001）。在校正混杂因素后，感染仍然与院内和长期全因死亡（OR，13.19，95%CI 4.59 至 37.87；HR，2.03，95%CI 1.52 至 2.71；P<0.001）和主要出血（OR，10.24，95%CI 6.17 至 16.98；HR，5.31，95%CI 3.49 至 8.08；P<0.001）独立相关。亚组分析证实了这些结果。
住院期间感染发生率较低，但与院内和长期结局较差相关。
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