感染性心内膜炎是二尖瓣手术患者的发病率预测因子

S. Supomo, Kelik Wagiyanto, A. Nugraha
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摘要

感染性心内膜炎(IE)常发展为风湿性心脏病(RHD),在疾病发展过程中有许多围手术期并发症。IE患者的心脏手术通常会导致术后并发症,从而降低生活质量。本研究旨在探讨心脏瓣膜手术患者术前IE与各种发病率的相关性。这是一项横断面研究,对2012年至2017年在日惹Dr. Sardjito总医院接受二尖瓣手术的60例患者的病历进行了二次数据分析。60例患者中有30例在二尖瓣手术前出现IE。IE组最常见的瓣膜疾病是二尖瓣狭窄(60%)。IE与二尖瓣术后心律失常和心脏事件显著相关,p=0.002 (PR: 6.91), ICU住院时间延长,p=0.011 (PR: 5.68),呼吸机使用时间延长,p=0.015 (PR: 12.43),重度肺动脉高压(PAH), p=0.033 (PR: 0.192)。分别有26例(87%)和29例(96.7%)IE患者在二尖瓣手术后延长ICU住院时间和延长呼吸机时间。IE组术后严重PAH的发生率低于非IE组(10% vs 36.7%)。IE与二尖瓣手术后心律失常风险增加、呼吸机使用时间延长和ICU住院时间延长显著相关
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Infective endocarditis as a morbidity predictor in patients who underwent mitral valve surgery
Infective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surgery
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