Tatlı Kış Tuba, Kış Mehmet, Güzel Tuncay, Mermutluoğlu Çiğdem
Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Izmir Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey.
Department of Cardiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):480-486. doi: 10.5114/aic.2024.145171. Epub 2024 Nov 20.
Infective endocarditis (IE) is the infection of the cardiac endothelium and heart valves. The incidence of IE has recently increased due to the widespread use of cardiac device therapies and prosthetic heart valves. Despite modern medical and surgical treatment methods, morbidity and mortality are still high, and it leads to serious complications. Evaluation of predictive factors leading to septic embolism, which is one of the most important complications in terms of mortality and morbidity, is important for improving outcomes in infective endocarditis.
In this study, we aimed to determine the predictive parameters of in-hospital mortality and septic embolism in patients with IE.
This was a retrospective cohort study. The patients were divided into two groups: group 1 (septic embolism or mortality +, 21 patients) and group 2 (septic embolism or mortality -, 43 patients). ROC analysis was performed to determine the cut-off value of the predictive parameters. Univariable and multivariable regression analysis was performed to identify parameters significantly associated with in-hospital mortality/septic embolism in infective endocarditis.
A total of 64 patients diagnosed with IE were included in the study. In the multivariable regression analysis, the parameters vegetation size (OR = 1.227; 95% CI: 1.019-1.477, = 0.031), aortic valve vegetation (OR = 0.088; 95% CI: 0.009-0.820, 0.033), mitral valve vegetation (OR = 0.082; 95% CI: 0.009-0.760, 0.028), albumin (OR = 0.185; 95% CI: 0.039-0.889, 0.035) and D-dimer (OR = 1.004; 95% CI: 1.000-1.009, 0.045) were found to be independent predictors for septic embolism and mortality in IE patients.
Vegetation size, high D-dimer and low serum albumin levels are predictors of in-hospital mortality and septic embolism in patients with IE.
感染性心内膜炎（IE）是心脏内皮和心脏瓣膜的感染。由于心脏装置治疗和人工心脏瓣膜的广泛使用，IE的发病率最近有所增加。尽管有现代医学和外科治疗方法，但发病率和死亡率仍然很高，并会导致严重并发症。评估导致脓毒性栓塞的预测因素对改善感染性心内膜炎的预后很重要，脓毒性栓塞是在死亡率和发病率方面最重要的并发症之一。
在本研究中，我们旨在确定IE患者住院死亡率和脓毒性栓塞的预测参数。
这是一项回顾性队列研究。患者分为两组：第1组（脓毒性栓塞或死亡阳性，21例患者）和第2组（脓毒性栓塞或死亡阴性，43例患者）。进行ROC分析以确定预测参数的临界值。进行单变量和多变量回归分析以确定与感染性心内膜炎患者住院死亡率/脓毒性栓塞显著相关的参数。
本研究共纳入64例诊断为IE的患者。在多变量回归分析中，发现赘生物大小（OR = 1.227；95% CI：1.019 - 1.477，P = 0.031）、主动脉瓣赘生物（OR = 0.088；95% CI：0.009 - 0.820，P = 0.033）、二尖瓣赘生物（OR = 0.082；95% CI：0.009 - 0.760，P = 0.028）、白蛋白（OR = 0.185；95% CI：0.039 - 0.889，P = 0.035）和D - 二聚体（OR = 1.004；95% CI：1.000 - 1.009，P = 0.045）是IE患者脓毒性栓塞和死亡的独立预测因素。
赘生物大小、高D - 二聚体和低血清白蛋白水平是IE患者住院死亡率和脓毒性栓塞的预测因素。
