Eleanor Lee, Kwok Hin Yiu, Willis Lam, C. Ko, Sung Yee Wong, K. Chan
Background : Acute aortic dissection is a potentially life-threatening condition among patients presenting with chest pain to emergency department. Without a prompt diagnosis and treatment, it carries high mortality and morbidity. Computed tomography (CT) of thorax and abdomen is one of the commonly used non-invasive investigation modalities for diagnosis of acute aortic dissection. Apart from making a diagnosis, there are a number of parameters in the CT images that may be helpful in providing prognostic information. In this study, prognostic values of these parameters in predicting both short term and intermediate term clinical outcomes of acute aortic dissection will be evaluated. Methods : This is a retrospective observational study involving 70 patients with diagnosis of acute aortic dissection recruited between January 2004 and December 2009 in North District Hospital in Hong Kong. Results : The mean age of these patients was 61 years old and 87% of them were male. The in-hospital mortality was 18.6% (13/70). The 30-day mortality was 24.3% (17/70). The mean maximal aortic diameter of all patients was 4.60 cm ± 1 cm. The mean maximal aortic diameter of the survived group was 4.49 cm ± 0.93 cm, whereas it was 5.22 cm ± 1.22 cm in the deceased group (p ¼ 0.032). Furthermore, the presence of patent false lumen (p ¼ 0.011) in the initial scan was also more prevalent in the deceased group. By univariate logistic regression analysis, the type of aortic dissection (OR 11.0, p ¼ 0.003), the larger maximal aortic diameter (OR 2.0, p ¼ 0.041), and also patent false lumen (OR 6.6, p ¼ 0.021) in the initial imaging were adverse prognostic indicators for in-hospital mortality. However, they were not found to be independent predictors with multivariable analysis. Conclusion : In addition to establishing the diagnosis of acute aortic dissection, the type of aortic dissection, the maximal aortic diameter, and also the patency of false lumen derived from contrast CT thorax and abdomen may also provide prognostic information with regards to in-hospital and 30-day mortality. Whether this information will lead to better clinical outcomes by earlier intervention requires further studies for con fi rmation.
{"title":"Usefulness of Computed Tomography Parameters in Predicting the Clinical Outcomes of Acute Aortic Dissection","authors":"Eleanor Lee, Kwok Hin Yiu, Willis Lam, C. Ko, Sung Yee Wong, K. Chan","doi":"10.55503/2790-6744.1210","DOIUrl":"https://doi.org/10.55503/2790-6744.1210","url":null,"abstract":"Background : Acute aortic dissection is a potentially life-threatening condition among patients presenting with chest pain to emergency department. Without a prompt diagnosis and treatment, it carries high mortality and morbidity. Computed tomography (CT) of thorax and abdomen is one of the commonly used non-invasive investigation modalities for diagnosis of acute aortic dissection. Apart from making a diagnosis, there are a number of parameters in the CT images that may be helpful in providing prognostic information. In this study, prognostic values of these parameters in predicting both short term and intermediate term clinical outcomes of acute aortic dissection will be evaluated. Methods : This is a retrospective observational study involving 70 patients with diagnosis of acute aortic dissection recruited between January 2004 and December 2009 in North District Hospital in Hong Kong. Results : The mean age of these patients was 61 years old and 87% of them were male. The in-hospital mortality was 18.6% (13/70). The 30-day mortality was 24.3% (17/70). The mean maximal aortic diameter of all patients was 4.60 cm ± 1 cm. The mean maximal aortic diameter of the survived group was 4.49 cm ± 0.93 cm, whereas it was 5.22 cm ± 1.22 cm in the deceased group (p ¼ 0.032). Furthermore, the presence of patent false lumen (p ¼ 0.011) in the initial scan was also more prevalent in the deceased group. By univariate logistic regression analysis, the type of aortic dissection (OR 11.0, p ¼ 0.003), the larger maximal aortic diameter (OR 2.0, p ¼ 0.041), and also patent false lumen (OR 6.6, p ¼ 0.021) in the initial imaging were adverse prognostic indicators for in-hospital mortality. However, they were not found to be independent predictors with multivariable analysis. Conclusion : In addition to establishing the diagnosis of acute aortic dissection, the type of aortic dissection, the maximal aortic diameter, and also the patency of false lumen derived from contrast CT thorax and abdomen may also provide prognostic information with regards to in-hospital and 30-day mortality. Whether this information will lead to better clinical outcomes by earlier intervention requires further studies for con fi rmation.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42024005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Risk is Small: Implant Complications of Leadless Pacemakers are related to Body Size","authors":"C. Lau","doi":"10.55503/2790-6744.1214","DOIUrl":"https://doi.org/10.55503/2790-6744.1214","url":null,"abstract":"","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46548185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Patients with chronic limb-threatening ischemia (CLTI) have poor prognosis. Prognostic nutritional index (PNI) is an established independent predictor of adverse outcome in various chronic illnesses. The use of PNI in patients with CLTI has not been studied. To evaluate the impact of PNI on 12-month adverse cardiovascular and limb outcomes in CLTI patients after endovascular revascularization therapy (ERT). Methods : 270 consecutive patients with CLTI (mean age 73.7 ± 11.9 years; 53% male) who underwent ERT at a single tertiary referral hospital between January 2009 and October 2016 were prospectively enrolled and analyzed. Patients were grouped by tertiles of PNI (lowest ≤ 37.5; middle 37.6 e 45.5; and highest > 45.5) at baseline de fi ned as 10 £ serum albumin (g/dL) þ 0.005 £ total lymphocyte count (per mm 3 ). Composite endpoint including all-cause mortality and amputation was considered as primary endpoint. All-cause mortality and amputation were also analyzed individually as secondary endpoints at 12-months. Multivariate Cox proportional hazards regression analyses were performed. Results : Mean PNI of the 3 groups were 32.8, 42.2 and 50.4 respectively. Co-morbidities such as end-stage renal failure, heart failure and Rutherford classi fi cations 6 were signi fi cantly more prevalent in the lowest PNI tertile (all P < 0.05). Patients in the highest PNI tertile was associated with lowest incidence of 12-month composite endpoint (9.9%), all-cause mortality (7.7%) and amputation (3.3%) compared to those in the middle (27.0%, 22.5%, 9.0%) and lowest (52.2%, 47.8%, 16.7%) respectively, and reached statistical signi fi cance (p < 0.05). Multivariate analysis demonstrated high PNI was an independent protective predictor of composite endpoint (adjusted Hazards Ratio (HR) 0.26, 95% con fi dence interval (CI): 0.12 e 0.57) and all-cause mortality (adjusted HR 0.20; 95% CI: 0.09 e 0.49). Kaplan-Meier analysis revealed that higher PNI was signi fi cantly associated with better prognosis with regard to amputation, all-cause mortality and primary composite endpoint (log rank < 0.05). Conclusions : Our results demonstrated that higher nutritional status de fi ned by prognostic nutritional index (PNI) predicted lower all-cause mortality and amputation rates in chronic limb-threatening ischemia patients after endovascular revascularization therapy.
背景:慢性肢体威胁性缺血(CLTI)患者预后较差。预后营养指数(PNI)是各种慢性疾病不良结局的独立预测指标。尚未研究PNI在CLTI患者中的应用。评估PNI对血管内血管重建术(ERT)后CLTI患者12个月心血管和肢体不良预后的影响。方法:连续270例CLTI患者(平均年龄73.7±11.9岁;对2009年1月至2016年10月在一家三级转诊医院接受ERT治疗的患者(53%男性)进行前瞻性登记和分析。患者按PNI分位数分组(最低≤37.5;中37.6 e 45.5;基线时血白蛋白(g/dL)为10英镑，总淋巴细胞计数(每mm 3)为0.005英镑。综合终点包括全因死亡率和截肢被认为是主要终点。在12个月时，全因死亡率和截肢也作为次要终点单独分析。进行多因素Cox比例风险回归分析。结果:3组患者PNI均值分别为32.8、42.2、50.4。终末期肾衰竭、心力衰竭和卢瑟福分类6等合共病在最低PNI分组中更为普遍(均P < 0.05)。PNI水平最高的患者12个月综合终点发生率(9.9%)、全因死亡率(7.7%)和截肢发生率(3.3%)分别低于中等水平(27.0%、22.5%、9.0%)和最低(52.2%、47.8%、16.7%)，差异均有统计学意义(p < 0.05)。多因素分析表明，高PNI是复合终点(校正危险比(HR) 0.26, 95%可信区间(CI): 0.12 e0.57)和全因死亡率(校正危险度0.20;95% CI: 0.09 e 0.49)。Kaplan-Meier分析显示，较高的PNI与截肢、全因死亡率和主要复合终点的预后显著相关(log rank < 0.05)。结论:我们的研究结果表明，由预后营养指数(PNI)确定的高营养状况预示着血管内血管重建术治疗后慢性肢体威胁缺血患者的全因死亡率和截肢率较低。
{"title":"Prognostic Nutritional Index as a Predictor of Prognosis in Patients with Chronic Limb Threatening Ischemia Who Underwent Endovascular Revascularization Therapy","authors":"W. Chi, Gmy Tan, B. Yan","doi":"10.55503/2790-6744.1209","DOIUrl":"https://doi.org/10.55503/2790-6744.1209","url":null,"abstract":"Background : Patients with chronic limb-threatening ischemia (CLTI) have poor prognosis. Prognostic nutritional index (PNI) is an established independent predictor of adverse outcome in various chronic illnesses. The use of PNI in patients with CLTI has not been studied. To evaluate the impact of PNI on 12-month adverse cardiovascular and limb outcomes in CLTI patients after endovascular revascularization therapy (ERT). Methods : 270 consecutive patients with CLTI (mean age 73.7 ± 11.9 years; 53% male) who underwent ERT at a single tertiary referral hospital between January 2009 and October 2016 were prospectively enrolled and analyzed. Patients were grouped by tertiles of PNI (lowest ≤ 37.5; middle 37.6 e 45.5; and highest > 45.5) at baseline de fi ned as 10 £ serum albumin (g/dL) þ 0.005 £ total lymphocyte count (per mm 3 ). Composite endpoint including all-cause mortality and amputation was considered as primary endpoint. All-cause mortality and amputation were also analyzed individually as secondary endpoints at 12-months. Multivariate Cox proportional hazards regression analyses were performed. Results : Mean PNI of the 3 groups were 32.8, 42.2 and 50.4 respectively. Co-morbidities such as end-stage renal failure, heart failure and Rutherford classi fi cations 6 were signi fi cantly more prevalent in the lowest PNI tertile (all P < 0.05). Patients in the highest PNI tertile was associated with lowest incidence of 12-month composite endpoint (9.9%), all-cause mortality (7.7%) and amputation (3.3%) compared to those in the middle (27.0%, 22.5%, 9.0%) and lowest (52.2%, 47.8%, 16.7%) respectively, and reached statistical signi fi cance (p < 0.05). Multivariate analysis demonstrated high PNI was an independent protective predictor of composite endpoint (adjusted Hazards Ratio (HR) 0.26, 95% con fi dence interval (CI): 0.12 e 0.57) and all-cause mortality (adjusted HR 0.20; 95% CI: 0.09 e 0.49). Kaplan-Meier analysis revealed that higher PNI was signi fi cantly associated with better prognosis with regard to amputation, all-cause mortality and primary composite endpoint (log rank < 0.05). Conclusions : Our results demonstrated that higher nutritional status de fi ned by prognostic nutritional index (PNI) predicted lower all-cause mortality and amputation rates in chronic limb-threatening ischemia patients after endovascular revascularization therapy.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44113938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shek Joyce, W. Yi, Wong Chun Kit, Jianlin Lu, Lam Wai Lung William, Mak Wai Man Vivien, Chan Ngai Yin
Cardiac tumour is a rare cause of heart failure. We report a case of right atrial mass found in a patient with known immunoglobulinG4-related disease (IgG4-RD), who presented with right heart failure, renal impairment and thrombocytopenia. Multimodal investigations were performed to reach the diagnosis of diffuse large B-cell lymphoma with cardiac involvement. Chemotherapy was initiated in an attempt for disease control. We highlight the potential link between IgG4-related disease and lymphoma.
{"title":"Right Atrial Mass with Inflow Obstruction in a patient with IgG4-related Disease","authors":"Shek Joyce, W. Yi, Wong Chun Kit, Jianlin Lu, Lam Wai Lung William, Mak Wai Man Vivien, Chan Ngai Yin","doi":"10.55503/2790-6744.1212","DOIUrl":"https://doi.org/10.55503/2790-6744.1212","url":null,"abstract":"Cardiac tumour is a rare cause of heart failure. We report a case of right atrial mass found in a patient with known immunoglobulinG4-related disease (IgG4-RD), who presented with right heart failure, renal impairment and thrombocytopenia. Multimodal investigations were performed to reach the diagnosis of diffuse large B-cell lymphoma with cardiac involvement. Chemotherapy was initiated in an attempt for disease control. We highlight the potential link between IgG4-related disease and lymphoma.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48018815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Survey of Perioperative Vascular Complications in Non-Cardiovascular Surgery in a Teaching Hospital in Western China","authors":"Yan J Hu, P. Chook, A. Wei, S. Kwong","doi":"10.55503/2790-6744.1098","DOIUrl":"https://doi.org/10.55503/2790-6744.1098","url":null,"abstract":"","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46314012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do Drug-Eluting Stents Cause Late Stent Thrombosis?","authors":"Wai-hong Chen, Shu-kin Li, C. Lau","doi":"10.55503/2790-6744.1095","DOIUrl":"https://doi.org/10.55503/2790-6744.1095","url":null,"abstract":"","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47584804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tea and Cardiovascular Diseases","authors":"L. Song, B. Cheung, M. Koo, C. Lau","doi":"10.55503/2790-6744.1101","DOIUrl":"https://doi.org/10.55503/2790-6744.1101","url":null,"abstract":"ET AL","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46592248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many people measure their blood pressure (BP) outside doctors ' of fi ces with a common goal of concerning their health status. Self-BP monitoring devices are widely accessible as health care products or available in different community institutes. Patients often seek their doctors ' advice on their BP readings in our daily practice. Current international guidelines recommend that correct self-BP measurement with validated devices can enhance patients ' self-management and drug compliance, improving overall BP control. While most of the clinicians are supportive of their patients ’ efforts, they are also concerned about the validity and reliability of the out-of-of fi ce BP readings. How can we effectively educate patients to get meaningful BP readings, which may improve their overall BP control? This article will review the current best evidence on patient self-BP monitoring.
{"title":"What Should Patients Know About Self Blood Pressure Measurement? A Review Article","authors":"S. Fu","doi":"10.55503/2790-6744.1072","DOIUrl":"https://doi.org/10.55503/2790-6744.1072","url":null,"abstract":"Many people measure their blood pressure (BP) outside doctors ' of fi ces with a common goal of concerning their health status. Self-BP monitoring devices are widely accessible as health care products or available in different community institutes. Patients often seek their doctors ' advice on their BP readings in our daily practice. Current international guidelines recommend that correct self-BP measurement with validated devices can enhance patients ' self-management and drug compliance, improving overall BP control. While most of the clinicians are supportive of their patients ’ efforts, they are also concerned about the validity and reliability of the out-of-of fi ce BP readings. How can we effectively educate patients to get meaningful BP readings, which may improve their overall BP control? This article will review the current best evidence on patient self-BP monitoring.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48664023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Though not recommended routinely in primary percutaneous coronary intervention (PCI), thrombus aspiration can be the gamechanger in treatment for selected patient. We report a case in which ST-segment elevation myocardial infarction (STEMI) due to a huge intracoronary saddle embolus in distal left main (LM) was successfully treated with dif fi cult intracoronary thrombectomy. We will discuss the potential strength of different thrombectomy devices which led to the
{"title":"Back to basic: A case of difficult intracoronary thrombectomy to left main bifurcation","authors":"Joyce Shek, Ho-Chuen Yuen, Ping-Tim Tsui","doi":"10.55503/2790-6744.1073","DOIUrl":"https://doi.org/10.55503/2790-6744.1073","url":null,"abstract":"Though not recommended routinely in primary percutaneous coronary intervention (PCI), thrombus aspiration can be the gamechanger in treatment for selected patient. We report a case in which ST-segment elevation myocardial infarction (STEMI) due to a huge intracoronary saddle embolus in distal left main (LM) was successfully treated with dif fi cult intracoronary thrombectomy. We will discuss the potential strength of different thrombectomy devices which led to the","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48106972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background : Infective endocarditis (IE) is associated with signi fi cant mortality and morbidity. This study aims to up-date the epidemiology of IE and to identify predictors of adverse outcome in the Chinese population in Hong Kong. Methods : This was a single-centre retrospective study of patients diagnosed with IE in Princess Margaret Hospital in Hong Kong during 2002 e 2016. Primary outcome was de fi ned as in-hospital mortality. Secondary outcomes included 1-year mortality, valvular surgical intervention, heart failure, stroke and systemic embolization. Results : In total, 196 patients with de fi nite or possible IE were included in the study. The incidence of IE was 2.26 per 100,000 person-years and had remained stable. Health care-associated IE (HCAIE) accounted for 32% of cases, with an increasing trend. Staphylococcus aureus was the most frequently isolated organism in the overall study population (37.8%) and among intravenous drug users (85.2%). In-hospital mortality remained high (29.1%) and was independently associated with higher Charlson Comorbidity Index (OR 1.24, p ¼ 0.001), heart failure (OR 5.65, p < 0.001) and the presence of large vegetation ≥ 1 cm (OR 4.67, p < 0.001). IE due to Streptococcus viridans was associated with a better outcome (OR 0.40, p ¼ 0.048). Discussion : This study showed that the incidence of IE remained stable during 2002 e 2016. There was an increasing proportion of HCAIE and S. aureus has become the most common causative organism. IE was associated with high mortality and morbidity. Independent predictors for in-hospital mortality were patient ' s medical comorbidity, large vegetation size and heart failure, while infection by viridans group streptococci was associated with reduced risk.
{"title":"A Retrospective Study on the Predictors of Outcome in Patients with Infective Endocarditis","authors":"Y. Yiu","doi":"10.55503/2790-6744.1070","DOIUrl":"https://doi.org/10.55503/2790-6744.1070","url":null,"abstract":"Background : Infective endocarditis (IE) is associated with signi fi cant mortality and morbidity. This study aims to up-date the epidemiology of IE and to identify predictors of adverse outcome in the Chinese population in Hong Kong. Methods : This was a single-centre retrospective study of patients diagnosed with IE in Princess Margaret Hospital in Hong Kong during 2002 e 2016. Primary outcome was de fi ned as in-hospital mortality. Secondary outcomes included 1-year mortality, valvular surgical intervention, heart failure, stroke and systemic embolization. Results : In total, 196 patients with de fi nite or possible IE were included in the study. The incidence of IE was 2.26 per 100,000 person-years and had remained stable. Health care-associated IE (HCAIE) accounted for 32% of cases, with an increasing trend. Staphylococcus aureus was the most frequently isolated organism in the overall study population (37.8%) and among intravenous drug users (85.2%). In-hospital mortality remained high (29.1%) and was independently associated with higher Charlson Comorbidity Index (OR 1.24, p ¼ 0.001), heart failure (OR 5.65, p < 0.001) and the presence of large vegetation ≥ 1 cm (OR 4.67, p < 0.001). IE due to Streptococcus viridans was associated with a better outcome (OR 0.40, p ¼ 0.048). Discussion : This study showed that the incidence of IE remained stable during 2002 e 2016. There was an increasing proportion of HCAIE and S. aureus has become the most common causative organism. IE was associated with high mortality and morbidity. Independent predictors for in-hospital mortality were patient ' s medical comorbidity, large vegetation size and heart failure, while infection by viridans group streptococci was associated with reduced risk.","PeriodicalId":53534,"journal":{"name":"Journal of the Hong Kong College of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41889551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：