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捷克共和国感染性心内膜炎的特征、处理和结局:ESC EORP EURO-ENDO 注册研究的前瞻性数据。

Characteristics, management, and outcome of infective endocarditis in the Czech Republic: prospective data from the ESC EORP EURO-ENDO registry.

出版信息

Bratisl Lek Listy. 2021;122(2):95-100. doi: 10.4149/BLL_2021_014.

DOI:10.4149/BLL_2021_014
PMID:33502876
Abstract

INTRODUCTION

Data describing contemporary profile of infective endocarditis (IE) in the Czech Republic are lacking. The aim of this study was to describe the current profile and outcomes of IE patients.

METHODS

Prospectively collected data on consecutive patients admitted for IE diagnosis between April 2016 and March 2018 to 11 main tertiary care cardiac centers in the Czech Republic were used for this analysis.

RESULTS

Among 208 patients, 88 patients (42.3 %) had native valve IE (NVIE), 56 patients (26.9 %) had prosthetic valve IE (PVIE), and 57 patients (27.4 %) had intracardiac device-related IE (CDRIE). The mean age was 61.66±15.54 years. Staphylococcus aureus was the most common etiological agent of IE (27.4 %), whereas Culture negative IE was present in 26.4 % patients. Surgery was performed during hospitalization in 112 (53.8 %) patients. In-hospital death occurred in 21.2 % patients, while 1-year mortality was 40.3 %. In patients, who had an indication for surgery, but the procedure was not performed, mortality was significantly higher (p=0.002).

CONCLUSION

High proportion of culture negative IE and IE related to artificial intra-cardiac materials calls for action. Furthermore, we show that cardiac surgery should be more often contemplated, especially in the presence of risk factors as septic shock and congestive heart failure (Tab. 6, Fig. 1, Ref. 32).

摘要

简介

缺乏描述捷克共和国当前感染性心内膜炎(IE)患者特征和结局的相关数据。本研究旨在描述捷克共和国 IE 患者的当前特征和结局。

方法

采用前瞻性方法收集 2016 年 4 月至 2018 年 3 月期间 11 个主要三级心脏中心确诊为 IE 的连续患者的数据,用于本分析。

结果

208 例患者中,88 例(42.3%)为原发性心脏瓣膜 IE(NVIE),56 例(26.9%)为人工心脏瓣膜 IE(PVIE),57 例(27.4%)为心脏器械相关 IE(CDRIE)。患者平均年龄为 61.66±15.54 岁。IE 的最常见病原体为金黄色葡萄球菌(27.4%),26.4%的患者为培养阴性 IE。112 例(53.8%)患者在住院期间接受了手术。21.2%的患者住院期间死亡,1 年死亡率为 40.3%。有手术指征但未行手术的患者死亡率显著升高(p=0.002)。

结论

培养阴性 IE 和与人工心脏材料相关的 IE 比例较高,需要采取行动。此外,我们还表明,心脏手术应更常考虑,尤其是在存在感染性休克和充血性心力衰竭等危险因素时(表 6,图 1,参考文献 32)。

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