Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Infectious Disease Unit, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cardiovasc Diabetol. 2022 Jun 30;21(1):120. doi: 10.1186/s12933-022-01557-x.
Type 2 diabetes mellitus (DM) is a frequent co-morbidity among patients suffering from infective endocarditis (IE). The aim of the study was to evaluate the impact of type 2 DM on the early-, intermediate- and long-term mortality of patients who underwent surgical treatment of endocarditis.
We performed an observational cohort study in the large tertiary center in Israel during 14 years. All data of patients who underwent surgical treatment of endocarditis, performed between 2006 and 2020 were extracted from the departmental database. Patients were divided into two groups: Group I (non-diabetic patients), and Group II (diabetic patients).
The study population includes 420 patients. Group I (non-diabetic patients), comprise 326 patients, and Group II (diabetic patients), comprise 94 patients. Mean follow-up duration was 39.3 ± 28.1 months. Short-term, 30-day and in-hospital mortality, also intermediate-term mortality (1- and 3-year) was higher in the DM group compared with the non-DM group, but did not reach statistical significance: 11.7% vs. 7.7%. (p = 0.215); 12.8% vs. 8.3% (p = 0.285); 20.2% vs. 13.2% (p = 0.1) and 23.4% vs. 15.6% (p = 0.09) respectively. Long-term, 5-year mortality was significantly higher in the DM group, compared to the non-DM group: 30.9% vs. 16.6% (p = 0.003). Furthermore, predictors for long-term mortality included diabetes (CI 1.056-2.785, p = 0.029), as demonstrated by regression analysis.
Diabetic patients have trend to increasing mortality at the short- and intermediate period post-surgery for IE, but this is not statistically significant. Survival of diabetic patients deteriorates after more than three years follow surgery. Diabetes is an independent predictor for long-term, 5-year mortality after surgical treatment of endocarditis, regardless of the patients age and comorbidities. Trial registration Ethical Committee of Sheba Medical Centre, Israel on 02.12. 2014, Protocol 4257.
2 型糖尿病（DM）是患有感染性心内膜炎（IE）的患者常见的合并症。本研究的目的是评估 2 型 DM 对接受心内膜炎手术治疗的患者的早期、中期和长期死亡率的影响。
我们在以色列的一家大型三级中心进行了一项观察性队列研究，时间为 14 年。从部门数据库中提取了 2006 年至 2020 年间接受心内膜炎手术治疗的所有患者的数据。患者分为两组：第 I 组（非糖尿病患者）和第 II 组（糖尿病患者）。
研究人群包括 420 名患者。第 I 组（非糖尿病患者）包括 326 名患者，第 II 组（糖尿病患者）包括 94 名患者。平均随访时间为 39.3±28.1 个月。短期、30 天和住院死亡率，以及中期死亡率（1 年和 3 年）在 DM 组高于非 DM 组，但无统计学意义：11.7%比 7.7%（p=0.215）；12.8%比 8.3%（p=0.285）；20.2%比 13.2%（p=0.1）和 23.4%比 15.6%（p=0.09）。长期、5 年死亡率在 DM 组显著高于非 DM 组：30.9%比 16.6%（p=0.003）。此外，回归分析显示，糖尿病是长期（5 年）死亡率的预测因素（CI 1.056-2.785，p=0.029）。
糖尿病患者在 IE 手术后的短期和中期有增加死亡率的趋势，但无统计学意义。糖尿病患者在手术后 3 年以上的随访中生存质量恶化。糖尿病是影响接受心内膜炎手术治疗患者 5 年长期死亡率的独立预测因素，与患者年龄和合并症无关。
以色列谢巴医疗中心伦理委员会于 2014 年 12 月 2 日注册，注册号为 4257。
