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巴西圣保罗感染性心内膜炎患者队列的临床特征及短期预后

Clinical aspects and short-term prognosis in a cohort of patients with infective endocarditis, São Paulo, Brazil.

作者信息

Becker Juliana Barros, Moisés Valdir Ambrósio, Barbosa Dulce Aparecida

机构信息

Universidade Federal de São Paulo, Hospital Universitário, São Paulo, SP, Brazil.

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.

出版信息

Rev Esc Enferm USP. 2025 Jul 28;59:e20250060. doi: 10.1590/1980-220X-REEUSP-2025-0060en. eCollection 2025.

Abstract

OBJECTIVE

To analyze the clinical characteristics of patients with infective endocarditis (IE) admitted to a tertiary hospital in Brazil, in-hospital mortality and predictors of readmission and mortality up to six months after hospital discharge.

METHOD

A retrospective cohort study, with data collected from medical records of patients with diagnosis of IE hospitalized during the study period. For comparative statistical analysis, patients were grouped according to survival and death outcomes.

RESULTS

A total of 204 patients participated in the study. Healthcare-associated IE accounted for 62.3% of cases, with Staphylococcus aureus as the predominant pathogen. Mortality was significantly associated with complications such heart failure and septic shock (p < 0.001). Diabetes mellitus (OR 7.76; p < 0.001) and acute kidney injury (OR 7.99; p = 0.016) were independent risk factors for hospital readmission. Overall mortality was 50.9%.

CONCLUSION

Short-term mortality was high. Healthcare-associated infections were predominant, and complications and comorbidities significantly affect mortality in IE patients. Identifying high-risk patients and optimizing management may improve outcomes.

摘要

目的

分析巴西一家三级医院收治的感染性心内膜炎(IE)患者的临床特征、住院死亡率以及出院后六个月内再入院和死亡的预测因素。

方法

一项回顾性队列研究,数据收集自研究期间诊断为IE的住院患者的病历。为进行比较统计分析,根据生存和死亡结果对患者进行分组。

结果

共有204名患者参与研究。医疗保健相关的IE占病例的62.3%,主要病原体为金黄色葡萄球菌。死亡率与心力衰竭和感染性休克等并发症显著相关(p < 0.001)。糖尿病(OR 7.76;p < 0.001)和急性肾损伤(OR 7.99;p = 0.016)是再入院的独立危险因素。总体死亡率为50.9%。

结论

短期死亡率较高。医疗保健相关感染占主导,并发症和合并症显著影响IE患者的死亡率。识别高危患者并优化管理可能改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c26b/12313321/45de093624b4/1980-220X-reeusp-59-e20250060-gf01.jpg

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