Buburuz Ana-Maria, Petris Antoniu, Costache Irina Iuliana, Jelihovschi Igor, Arsenescu-Georgescu Catalina, Iancu Luminita Smaranda
Department of Cardiology, "Grigore T. Popa" University of Medicine and Pharmacy, 6 University Street, 700115 Iasi, Romania.
Department of Microbiology, "Grigore T. Popa" University of Medicine and Pharmacy, 6 University Street, 700115 Iasi, Romania.
Pathogens. 2021 May 2;10(5):551. doi: 10.3390/pathogens10050551.
This study aimed to identify possible differences between blood culture-negative and blood culture-positive groups of infective endocarditis (IE), and explore the associations between biological parameters and in-hospital mortality.
This was a retrospective study of patients hospitalized for IE between 2007 and 2017. Epidemiological, clinical and paraclinical characteristics, by blood culture-negative and positive groups, were collected. The best predictors of in-hospital mortality based on the receiver-operating characteristic (ROC) analysis and AUC (area under the curve) results were identified.
A total of 126 IE patients were included, 54% with negative blood cultures at admission. Overall, the in-hospital mortality was 28.6%, higher in the blood culture-negative than positive group (17.5% vs. 11.1%, = 0.207). A significant increase in the Model for End-Stage Liver Disease Excluding International Normalized Ratio (MELD-XI) score was observed in the blood culture-negative group ( = 0.004), but no baseline characteristics differed between the groups. The best laboratory predictors of in-hospital death in the total study group were the neutrophil count (AUC = 0.824), white blood cell count (AUC = 0.724) and MELD-XI score (AUC = 0.700).
Classic laboratory parameters, such as the white blood cell count and neutrophil count, were associated with in-hospital mortality in infective endocarditis. In addition, MELD-XI was a good predictor of in-hospital death.
本研究旨在确定感染性心内膜炎（IE）血培养阴性组和血培养阳性组之间可能存在的差异，并探讨生物学参数与院内死亡率之间的关联。
这是一项对2007年至2017年因IE住院患者的回顾性研究。收集了血培养阴性组和阳性组的流行病学、临床和辅助检查特征。基于受试者工作特征（ROC）分析和曲线下面积（AUC）结果确定了院内死亡率的最佳预测指标。
共纳入126例IE患者，入院时血培养阴性者占54%。总体而言，院内死亡率为28.6%，血培养阴性组高于阳性组（17.5%对11.1%，P = 0.207）。血培养阴性组终末期肝病模型（不包括国际标准化比值）（MELD-XI）评分显著升高（P = 0.004），但两组间基线特征无差异。在整个研究组中，院内死亡的最佳实验室预测指标是中性粒细胞计数（AUC = 0.824）、白细胞计数（AUC = 0.724）和MELD-XI评分（AUC = 0.700）。
经典实验室参数，如白细胞计数和中性粒细胞计数，与感染性心内膜炎的院内死亡率相关。此外，MELD-XI是院内死亡的良好预测指标。
