Abstract

Background

Infective endocarditis is a serious septic disease, and the epidemiological profile has changed over the last decade. However, there is a paucity of data regarding the current outcome and predictor of in-hospital mortality in patients with infective endocarditis.

Methods

Consecutive patients diagnosed as infective endocarditis based on the modified Duke criteria at Kansai Medical University hospital from January 2006 to June 2019 were prospectively included. The primary outcome was in-hospital mortality. Cox proportional hazards modelling was used to assess risk factors of in-hospital mortality.

Results

Of 137 consecutive patients with infective endocarditis (age 60 ± 17 years-old, 62% men, 65% underlying cardiac disease, 11% chronic haemodialysis), 18 (13%) died during hospitalisation. Age and sex were not associated with in-hospital mortality. Patients on chronic haemodialysis exhibited significantly higher in-hospital mortality rate than those without (47 vs. 9%). After adjusting for comorbidities in a multivariate Cox proportional hazards model, chronic haemodialysis was a significant predictor of in-hospital mortality [hazard ratio (HR) 4.22, 95% confidential interval (CI): 1.49–12.0, p < 0.01], independently of C-reactive protein (per 1 mg/dl; HR 1.07, 95%CI: 1.02–1.12, p < 0.05).

Conclusions

Infective endocarditis in patients on chronic haemodialysis is a serious life-threatening condition that requires early diagnosis and an effective therapeutic approach.

中文翻译：

---

感染性心内膜炎患者住院死亡率的预测因素

摘要

背景

感染性心内膜炎是一种严重的脓毒症，流行病学特征在过去十年中发生了变化。然而，关于感染性心内膜炎患者目前结局和院内死亡率预测因子的数据很少。

方法

前瞻性纳入了 2006 年 1 月至 2019 年 6 月在关西医科大学医院根据修改后的杜克标准诊断为感染性心内膜炎的连续患者。主要结局是住院死亡率。Cox比例风险模型用于评估住院死亡率的危险因素。

结果

连续 137 例感染性心内膜炎患者（年龄 60 ± 17 岁，62% 男性，65% 潜在心脏病，11% 慢性血液透析），18 例（13%）在住院期间死亡。年龄和性别与住院死亡率无关。接受慢性血液透析的患者的住院死亡率显着高于未接受血液透析的患者（47% vs. 9%）。在多变量 Cox 比例风险模型中调整合并症后，慢性血液透析是住院死亡率的重要预测指标 [风险比 (HR) 4.22, 95% 机密区间 (CI): 1.49–12.0, p  < 0.01]，独立于C 反应蛋白（每 1 mg/dl；HR 1.07, 95%CI: 1.02–1.12, p  < 0.05）。

结论

慢性血液透析患者的感染性心内膜炎是一种严重的危及生命的疾病，需要早期诊断和有效的治疗方法。