Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Dec 28;45(12):1403-1411. doi: 10.11817/j.issn.1672-7347.2020.190667.
To explore the basic clinical characteristics and relevant factors affecting the early postoperative prognosis in patients with infective endocarditis (IE).
A total of 702 patients with IE, who underwent surgery in Xiangya Hospital, Central South University from January 1981 to June 2019, were studied and the data were collected through the paper records and the hospital information system. The patients from January 1981 to June 2010 served as an early group (=224), and other patients from July 2010 to June 2019 served as a recent group (=478). Independent risk factors for early postoperative death were determined by logistic regression analysis.
The mean age of the 702 patients was 36.7±16.1 years, and the male accounted for 68.1%. Preoperative stroke occurred in 71 patients (10.1%), and dialysis was done in 14 patients (2%) preoperatively. were the pathogenic bacteria in 172 patients, accounting for 59.5% of all positive blood culture results. In the early group, the percentage of IE combined with congenital heart disease was significantly higher than that in the recent group [77 patients (34.4%) in the early group vs 22 patients (4.6%) in the recent group; <0.05]. Postoperative stroke occurred in 15 patients (2.1%), while 59 patients (7%) required new dialysis postoperatively because of renal insufficiency. Twenty-nine patient died in the post-operation, with 4.1% in 30-day mortality. Logistic regression analysis revealed that the high preoperative New York Heart Association (NYHA) grade of cardiac function (OR=3.22, 95% CI 1.50-6.88; <0.01), postoperative stroke (OR=5.75, 95% CI 1.22-27.07; <0.05), postoperative dialysis (OR=15.53, 95% CI 3.50-68.82; <0.01), perivalvular abscess (OR=13.19, 95% CI 3.83-45.42; <0.01) and multivalve involvement (OR=3.57, 95% CI 1.24-10.30; <0.05) were the independent risk factors for early mortality.
is the most common pathogenic bacteria in the patients with IE. Surgery for IE can obtain a satisfactory early outcomes. High preoperative NYHA grade of cardiac function, postoperative stroke, postoperative dialysis, perivalvular abscess and multivalve involvement are the independent risk factors for early mortality.
探讨感染性心内膜炎（IE）患者术后早期预后的基本临床特征及相关影响因素。
回顾性分析 1981 年 1 月至 2019 年 6 月在中南大学湘雅医院接受手术治疗的 702 例 IE 患者的临床资料，采集患者的纸本病历和医院信息系统数据。1981 年 1 月至 2010 年 6 月的患者作为早期组（=224），2010 年 7 月至 2019 年 6 月的患者作为近期组（=478）。采用 logistic 回归分析确定术后早期死亡的独立危险因素。
702 例患者的平均年龄为 36.7±16.1 岁，男性占 68.1%。术前发生脑卒中 71 例（10.1%），术前透析 14 例（2%）。172 例患者的致病菌为，占所有阳性血培养结果的 59.5%。在早期组中，IE 合并先天性心脏病的比例明显高于近期组[77 例（34.4%）vs 22 例（4.6%）；<0.05]。术后发生脑卒中 15 例（2.1%），59 例（7%）因肾功能不全需术后行新透析治疗。术后共 29 例死亡，30 天死亡率为 4.1%。logistic 回归分析显示，术前纽约心脏病协会（NYHA）心功能分级较高（OR=3.22，95%CI 1.50-6.88；<0.01）、术后脑卒中（OR=5.75，95%CI 1.22-27.07；<0.05）、术后透析（OR=15.53，95%CI 3.50-68.82；<0.01）、瓣周脓肿（OR=13.19，95%CI 3.83-45.42；<0.01）和多瓣膜受累（OR=3.57，95%CI 1.24-10.30；<0.05）是术后早期死亡的独立危险因素。
是 IE 患者最常见的致病菌。IE 患者行手术治疗可获得满意的早期预后。术前 NYHA 心功能分级较高、术后脑卒中、术后透析、瓣周脓肿和多瓣膜受累是术后早期死亡的独立危险因素。
