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感染性心内膜炎炎症评分对院内死亡率的预测强度

Predictive strength of inflammatory scores for in-hospital mortality in infective endocarditis.

作者信息

Cicek Vedat, Erdem Almina, Kilic Sahhan, Tay Burak, Kamil Yemis Mustafa, Taslicukur Solen, Oguz Mustafa, Oz Ahmet, Selcuk Murat, Cinar Tufan, Bagci Ulas

机构信息

Machine & Hybrid Intelligence Lab, Department of Radiology, Northwestern University, 737 N. Michigan Avenue Suite 1600, 60611, Chicago, IL, USA.

Sultan II. Abdülhamid Han Training and Research Hospital, Department of Cardiology, Health Sciences University, Istanbul, Turkey.

出版信息

Herz. 2025 Jan 24. doi: 10.1007/s00059-024-05292-9.

Abstract

BACKGROUND

Inflammatory markers have been proposed as prognostic tools for predicting in-hospital mortality in infective endocarditis (IE). Nonetheless, it is unclear whether these markers provide additional prognostic value over established indicators. This study compared nine different inflammation scores to assess their effectiveness in enhancing the prediction of in-hospital mortality.

METHODS

Patients with IE diagnosed between 2017 and 2023 at two cardiology centers in Istanbul were included in this study. Pre-treatment inflammatory markers were obtained from the hospital electronic database system. In-hospital mortality prognostication was assessed using Cox proportional hazards models.

RESULTS

A total of 122 patients who were diagnosed with IE were included in the analysis. Overall, 38 patients died during the hospital stay. The patients were categorized into two groups based on their mortality status. The prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were identified as statistically significant predictors of in-hospital mortality. Based on the results of Cox regression analysis, the PNI (hazard ratio [HR]: 0.921, 95% confidence interval [CI]: 0.853-0.994, p = 0.035) emerged as the only independent predictor of in-hospital mortality of IE patients.

CONCLUSION

Nine inflammatory scores were evaluated in this study. The PNI, PLR, and mGPS were statistically significant predictors of in-hospital mortality in patients with IE. The PNI was identified as the optimal score.

摘要

背景

炎症标志物已被提议作为预测感染性心内膜炎(IE)患者院内死亡率的预后工具。然而,尚不清楚这些标志物是否能在既定指标的基础上提供额外的预后价值。本研究比较了九种不同的炎症评分,以评估它们在增强院内死亡率预测方面的有效性。

方法

本研究纳入了2017年至2023年期间在伊斯坦布尔的两个心脏病中心诊断为IE的患者。治疗前的炎症标志物数据来自医院电子数据库系统。使用Cox比例风险模型评估院内死亡率预后。

结果

共有122例被诊断为IE的患者纳入分析。总体而言,38例患者在住院期间死亡。根据死亡率状况将患者分为两组。预后营养指数(PNI)、血小板与淋巴细胞比值(PLR)和改良格拉斯哥预后评分(mGPS)被确定为院内死亡率的统计学显著预测因素。基于Cox回归分析结果,PNI(风险比[HR]:0.921,95%置信区间[CI]:0.853 - 0.994,p = 0.035)成为IE患者院内死亡率的唯一独立预测因素。

结论

本研究评估了九种炎症评分。PNI、PLR和mGPS是IE患者院内死亡率的统计学显著预测因素。PNI被确定为最佳评分。

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