二尖瓣脱垂患者感染性心内膜炎的临床及医疗费用后果

Clinical and health care cost consequences of infective endocarditis in mitral valve prolapse.

作者信息

Frary C J, Devereux R B, Kramer-Fox R, Roberts R B, Ruchlin H S

机构信息

Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021.

出版信息

Am J Cardiol. 1994 Feb 1;73(4):263-7. doi: 10.1016/0002-9149(94)90231-3.

DOI:10.1016/0002-9149(94)90231-3

PMID:8296757

Abstract

Although mitral valve prolapse (MVP) predisposes to infective endocarditis (IE), both the clinical consequences of IE and the increment in health care costs it imposes on patients with MVP remain uncertain. Accordingly, 21 MVP patients with IE and 41 age- and sex-matched control subjects with initially uncomplicated MVP were followed (95% complete) a mean of 8 years. Outcomes included death, complications, health care use and cumulative incremental costs. More MVP patients with IE died (25 vs 5%, p < 0.05), underwent valve surgery (40 vs 8%, p < 0.01), had heart failure (50 vs 5%, p < 0.01) or embolization (53 vs 11%, p < 0.01), underwent cardiac catheterization (40 vs 13%), and saw their physicians > 2 times per year (88 vs 33%). The cumulative incremental cost of IE (1990 dollars) was $46,132 per case. Thus, IE in patients with MVP causes considerable cumulative morbidity and incremental health care costs.

摘要

尽管二尖瓣脱垂（MVP）易引发感染性心内膜炎（IE），但IE的临床后果以及它给MVP患者带来的医疗费用增加情况仍不明确。因此，对21例患有IE的MVP患者以及41例年龄和性别匹配、最初无并发症的MVP对照受试者进行了随访（95%完整），平均随访8年。结果包括死亡、并发症、医疗保健使用情况和累积增量成本。更多患有IE的MVP患者死亡（25%对5%，p<0.05），接受瓣膜手术（40%对8%，p<0.01），出现心力衰竭（50%对5%，p<0.01）或栓塞（53%对11%，p<0.01），接受心脏导管插入术（40%对13%），并且每年看医生超过2次（88%对33%）。IE的累积增量成本（1990美元）为每例46,132美元。因此，MVP患者的IE会导致相当大的累积发病率和增量医疗保健成本。