Transurethral resection of the prostate (TUR-P) and associated risk of infective endocarditis.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2024-12-20 DOI:10.1007/s15010-024-02450-3

Emil Loldrup Fosbøl, Anna Stahl, Andreas Røder, Cecilie Bagi Nordsten, Lauge Østergaard, Thomas S G Sehested, Anders Dahl, Nikolaj Ihlemann, Henning Bundgaard, Kasper Iversen, Nana Valeur, Gunnar Gislason, Christian Torp-Pedersen, Marianne Voldstedlund, Per Bagi, Lars Køber

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引用次数: 0

Abstract

Purpose: Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.

Methods: We examined risk of IE following TUR-P between 2010 and 2020 in comparison with an age-matched (match-ratio 1:1) cohort from the background population. Patients were considered exposed to TUR-P related IE 6 months after TUR-P. Comparisons were estimated using cumulative incidences and multivariable time-dependent Cox regression models.

Results: A total of 25,781 males underwent TUR-P (11.4% diagnosed with prostate cancer). Median age was 70.7 years (25-75 percentiles, 64.9-76.3 years). In the TUR-P group, 901 (3.5%) patients had bacteremia and 44 (0.2%) patients developed IE within 6 months following index. The most common microorganism in IE-cases was Enterococcus faecalis (72.7%). The incidence of IE was higher < 6 months after TUR-P (34.64 (25.78-46.55)) IEs per 10,000 person years) than 6-12 months after TUR-P (8.37 (5.46-12.84) IEs per 10,000 person years). TUR-P was associated with a higher hazard ratio of IE within 6 months (age-adjusted HR 8.16, 95% CI 3.06-21.79), but not 6-12 months after TUR-P (adj. HR 2.15 (0.91-5.07)).

Conclusions: TUR-P was associated with an eight-fold higher risk of IE compared with age-matched controls within 6 months after surgery. Although the absolute risk was low, TUR-P seems to be a significant risk factor for IE and this warrant consideration for development of better prophylactic interventions.

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经尿道前列腺切除术（turp）与感染性心内膜炎的相关风险

目的：菌血症是众所周知的手术并发症，可能导致感染性心内膜炎（IE）。经尿道前列腺切除术（turp）可能引起菌血症，但相关的IE风险尚未得到很好的描述。我们的目的是检查turp术后感染性心内膜炎的风险。方法：我们检查了2010年至2020年间turp术后IE的风险，并与背景人群年龄匹配（匹配比1:1）的队列进行了比较。患者在turp后6个月被认为暴露于turp相关的IE。使用累积发生率和多变量随时间变化的Cox回归模型估计比较。结果：共有25,781名男性接受了turp检查（11.4%诊断为前列腺癌）。中位年龄为70.7岁（25-75百分位数，64.9-76.3岁）。在turp组中，901例（3.5%）患者出现菌血症，44例（0.2%）患者在指数后6个月内出现IE。ie病例中最常见的微生物为粪肠球菌（Enterococcus faecalis）（72.7%）。结论：术后6个月内，与年龄匹配的对照组相比，turp与IE风险高8倍相关。虽然绝对风险很低，但turp似乎是IE的一个重要风险因素，这值得考虑开发更好的预防性干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.