K. Meidrops, J. D. Osipovs, Arina Zuravlova, V. Groma, Mārtiņš Kalējs, E. Petrošina, Roberts Leibuss, E. Strīķe, U. Dumpis, A. Erglis, P. Stradins
{"title":"与需要心脏手术的感染性心内膜炎患者死亡率相关的危险因素:一项基于拉脱维亚人口的研究","authors":"K. Meidrops, J. D. Osipovs, Arina Zuravlova, V. Groma, Mārtiņš Kalējs, E. Petrošina, Roberts Leibuss, E. Strīķe, U. Dumpis, A. Erglis, P. Stradins","doi":"10.23736/S0021-9509.22.12092-6","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nIncreased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well risk factors and laboratory indices predictive of adverse outcomes of the disease.\n\n\nMETHODS\nClinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia between 2015 and 2019 were analysed.\n\n\nRESULTS\nWe analysed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S.aureus infection (HR 2.27, 95% CI 1.36-3.80; p=0.002) and systemic embolization of vegetations (HR 1.63, 95% CI 1.00-2.64; p=0.048). Perivalvular complications (HR 1.98, 95% CI 1.19-3.29; p=0.009) were found to be independently associated with mortality in multivariate analysis (HR 1.99, 95% CI 1.05-3.78; p=0.035). One-year survival was 78.3%, whereas three-year ‒ 71.3%.\n\n\nCONCLUSIONS\nIntrahospital mortality of surgically treated IE patients was 11.2%, however one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery: a study based on Latvian population.\",\"authors\":\"K. Meidrops, J. D. Osipovs, Arina Zuravlova, V. Groma, Mārtiņš Kalējs, E. Petrošina, Roberts Leibuss, E. Strīķe, U. Dumpis, A. Erglis, P. Stradins\",\"doi\":\"10.23736/S0021-9509.22.12092-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\nIncreased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well risk factors and laboratory indices predictive of adverse outcomes of the disease.\\n\\n\\nMETHODS\\nClinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia between 2015 and 2019 were analysed.\\n\\n\\nRESULTS\\nWe analysed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S.aureus infection (HR 2.27, 95% CI 1.36-3.80; p=0.002) and systemic embolization of vegetations (HR 1.63, 95% CI 1.00-2.64; p=0.048). 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Laboratory indices were not predictive of adverse outcomes.\",\"PeriodicalId\":101333,\"journal\":{\"name\":\"The Journal of cardiovascular surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of cardiovascular surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.23736/S0021-9509.22.12092-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of cardiovascular surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.23736/S0021-9509.22.12092-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
预期寿命的延长、医学和心内装置的发展、心脏手术的可及性、风湿性心脏病患病率的降低正在改变感染性心内膜炎患者的概况,从而改变不良事件的危险因素。这项以单中心为基础的研究覆盖了整个拉脱维亚人口,旨在评估接受心脏手术的感染性心内膜炎患者的院内死亡率和3年死亡率,以及预测疾病不良后果的危险因素和实验室指标。方法分析拉脱维亚里加保罗斯特拉丁斯临床大学医院2015年至2019年收治的心脏外科患者的临床资料、实验室和仪器分析数据、手术和重症监护病房记录。结果:我们分析了233例手术治疗的242例感染性心内膜炎患者的数据。患者中位年龄为57.00(45.00-68.00)岁。院内死亡率为11.16%。单因素分析中与死亡率相关的危险因素为金黄色葡萄球菌感染(HR 2.27, 95% CI 1.36-3.80;p=0.002)和全身性植被栓塞(HR 1.63, 95% CI 1.00-2.64;p = 0.048)。瓣周并发症(HR 1.98, 95% CI 1.19-3.29;p=0.009)在多变量分析中发现与死亡率独立相关(HR 1.99, 95% CI 1.05-3.78;p = 0.035)。1年生存率为78.3%,3年生存率为71.3%。结论手术治疗的IE患者院内死亡率为11.2%,但1年和3年死亡率分别为21.7%和28.7%。瓣周并发症与死亡率独立相关。实验室指标不能预测不良结局。
Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery: a study based on Latvian population.
BACKGROUND
Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well risk factors and laboratory indices predictive of adverse outcomes of the disease.
METHODS
Clinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia between 2015 and 2019 were analysed.
RESULTS
We analysed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S.aureus infection (HR 2.27, 95% CI 1.36-3.80; p=0.002) and systemic embolization of vegetations (HR 1.63, 95% CI 1.00-2.64; p=0.048). Perivalvular complications (HR 1.98, 95% CI 1.19-3.29; p=0.009) were found to be independently associated with mortality in multivariate analysis (HR 1.99, 95% CI 1.05-3.78; p=0.035). One-year survival was 78.3%, whereas three-year ‒ 71.3%.
CONCLUSIONS
Intrahospital mortality of surgically treated IE patients was 11.2%, however one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.