[在一家无心脏外科手术的医院中，手术对感染性心内膜炎死亡率的影响]
[Impact of surgery on the mortality of infective endocarditis in a hospital without cardiac surgery].
作者信息
Escudero-Sánchez R, Mendoza Lizardo S S, Batlle López E, Campelo Gutierrez C, Losa García J E, Velasco Arribas M
机构信息
Rosa Escudero Sánchez, Servicio Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Ctra Colmenar Viejo, Km 9,1 (28034) Madrid (Spain).
出版信息
Rev Esp Quimioter. 2020 Dec;33(6):436-443. doi: 10.37201/req/005.2020. Epub 2020 Oct 13.
OBJECTIVE
Infective endocarditis has a high morbidity and mortality and requires a coordinated medical-surgical management. The objective was to analyse the impact of surgery on mortality in a hospital without cardiac surgery.
METHODS
Evaluation of a prospective cohort of patients with infective endocarditis diagnosed between August 2011 and January 2016 according to modified Duke's criteria.
RESULTS
Sixty-four patients were included, of whom seventeen patients were operated (26.6%). Mortality was 32.8% and it was associated with chronic obstructive pulmonary disease history, staphylococci coagulase-negative and the appearance of complications, as valvular insufficiency and embolisms in the central nervous system; cardiac surgery was not associated with mortality. Four patients (6,6%) were not operated despite indication of cardiac surgery. The main reason for not been intervened was the poor presurgical prognosis (44.7%).
CONCLUSIONS
Mortality due to infective endocarditis in a hospital without cardiac surgery is high. The need for interhospital teams is strengthened.
目的
感染性心内膜炎发病率和死亡率较高，需要内科与外科协同治疗。本研究旨在分析在一家没有心脏外科的医院中，手术对死亡率的影响。
方法
对2011年8月至2016年1月期间根据改良Duke标准确诊的感染性心内膜炎患者的前瞻性队列进行评估。
结果
纳入64例患者，其中17例接受手术（26.6%）。死亡率为32.8%，其与慢性阻塞性肺疾病史、凝固酶阴性葡萄球菌以及并发症（如瓣膜关闭不全和中枢神经系统栓塞）的出现相关；心脏手术与死亡率无关。4例患者（6.6%）尽管有心脏手术指征但未接受手术。未进行干预的主要原因是术前预后较差（44.7%）。
结论
在一家没有心脏外科的医院中，感染性心内膜炎导致的死亡率较高。加强医院间团队协作的必要性凸显。
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