Analysis Of Clinical Characteristics And Prognostic Factors Of Surgical Treatment Of Infective Endocarditis

ObjectiveWith the development of the medical level,certain progress has been made in the diagnosis and treatment of IE,but the incidence of IE has increased,and there is a higher mortality rate.Clarifying the clinical characteristics and prognostic risk factors of IE is of great significance for identifying patients with poor prognosis and guiding treatment.Previous studies have analyzed the risk factors related to the prognosis of IE,but the conclusions of the studies are different.Therefore,the purpose of this paper is to analyze the clinical characteristics of IE,and further discover the risk factors associated with IE patients’ death within one year of surgery.MethodsThis study included complete case data of patients with infective endocarditis diagnosed with infective endocarditis from June 2010 to June 2019 to the Department of Cardiovascular Surgery,Xiangya Hospital of Central South University.All patients were divided into complication group and non-complication group,death group within one year and survival group,and group comparisons were made.The basic clinical data,prognosis and survival of IE patients,a rare case,and risk factors for death within one year after surgery were statistically analyzed.Logistic regression analysis was used to screen out independent risk factors for death in patients with IE within one year after surgery.The Kaplan-Meier method was used to draw the survival curve of each independent risk factor group,and the difference in survival curve between the groups was compared by log rank test.ResultsThis study finally included 394 patients who met the inclusion and exclusion criteria.The follow-up time was from 20 months to 128 months,with a median time of 74 months and an average of 69.1 months.Preoperative fever,renal insufficiency,preoperative embolism,paravalvular abscess,preoperative hemoglobin and albumin were significantly different between the complication group and the non-complication group.Preoperative heart function grade IV,fungal infection,paravalvular abscess,involvement of multiple valves,and postoperative stroke are independent risk factors for death in patients with IE within one year after surgery.Conclusions1.The most common clinical symptoms of IE patients are fever.Other common clinical symptoms include chest tightness,shortness of breath and weight loss.Chest pain is relatively rare.2.The main underlying disease of IE is congenital heart disease,followed by arrhythmia and rheumatic heart valve disease.3.Streptococcus is the main pathogenic microorganism of IE,followed by Staphylococcus aureus.4.Patients with IE with fever,renal insufficiency,preoperative embolism and paravalvular abscess,and lower preoperative hemoglobin and albumin are more likely to have complications.5.5.Preoperative NYHA IV,fungal infection,paravalvular abscess,involvement of multiple valves,and postoperative stroke are independently associated with death within one year of IE patients.6 figures;6 tables;62 references in text;50 references in review...