Retrospective Study And Prognostic Analysis Of Infective Endocarditis In A 3A Grade Hospital Of Guangxi

Objective:To retrospectively analyze the clinical data of patients with infective endocarditis(IE),to summarize the symptoms and signs of IE,the imaging findings(echocardiography),the distribution and the characteristics of pathogens,antibiotics or surgical treatment and prognosis;to explore the factors affecting the prognosis of patients,thus improving the clinical understanding of diagnosis and the treatment of IE.Methods:To query the Hospital Information System(HIS)and collect the information that clinically diagnosed with IE in a 3 A grade Hospital of Guangxi,from July 2012 to July 2019.Including clinical manifestations,blood culture,echocardiography,antibiotics administrations or surgical treatment and prognosis.Results:Combined with the modified Duke diagnostic criteria,123 patients were collected.The main symptoms were fever,shortness of breath,and chest tightness;the main signs were cardiac murmurs.121 patients underwent echocardiography,112 cases of vegetations were detected;all patients were sent for blood culture at the same time,the positive rate was 61.79%,and the culture results suggested that Streptococcus(51.32%)and Staphylococcus(18.42%)were the main pathogens of IE.78 cases(63.41%)were treated by internal medicine,and the adminstration was based on anti-infection;120 cases(97.56%)of antibiotics were used,391 cases were used in total,and 121 cases were used antibiotics alone,accounting for 30.95%;the combination of drugs were 240 cases,accounting for 61.38%;triple combination medication,29 cases,accounting for 7.42%.45 cases(36.59%),on the basis of anti-infection,were treated surgically according to the patient’s situation,including valve replacement surgery or valvuloplasty.The clinical outcomes were:13 patients(10.57%)died,110 patients(89.43%)improved,23 patients(18.70%)combined with complications,and 13 patients(100%)had complications and died.Univariate regression analysis indicated that the risk factors for IE death were hemoglobin<90g/L,serum albumin<30g/L,and complications during hospitalization.Further multivariate regression analysis showed that serum albumin<30g/L(OR=0.128,95%CI 0.017～0.941,p=0.043)and complications during hospitalization(OR=43.699,95%CI 7.255～266.432,p<0.001)is an independent factor affecting the prognosis of patients.Conclusion:Low serum albumin and complications during hospitalization are important factors leading to clinical death.IE patients with clinically low serum albumin and hospital complications should be identified and paid close attention to as soon as possible.