Analysis Of Delayed Diagnosis Of Infective Endocarditis

Objective:Analyze the problem of IE delayed diagnosis with a view to early diagnosis of the disease.Methods:A total of 122 patients with infective endocarditis admitted to cardiothoracic surgery during the period from January 2012 to December 2021 were reviewed.The patient data were divided into delayed diagnosis group(49 cases)and control group(73cases)based on whether they were included in the IE diagnosis process due to their suspected diagnostic conditions.The clinical data of the two groups were compared.Results:The patient was 16 to 81 years old,with an average age of 42.81±16.94 years.Gender:male 85(69.7%),female 37(30.3%),male to female ratio:2.3:1.The initial symptom of 83 patients in the group was fever,but clinicians ignored the diagnostic condition and did not perform IE differential diagnosis in 79 patients(95.18%);76 cases had cardiac predisposing factors,but 44 cases(57.89%)were ignored,60 cases had vascular manifestations,and 33 cases(55%)were ignored.Immunological manifestations:81 cases appeared,37 cases were ignored(46.25%);Other serological evidence showed that 78 cases were present and 49 cases(62.82%)were ignored.59bacterial cultures showed IE positive,with a positive culture rate of only 48.36%.Ultrasound showed positive results in 111 cases(90.98%).Diagnostic criteria for delayed diagnosis include cardiac predisposing factors(Χ~2=14.947,P<0.05),vascular manifestations(Χ~2=19.862,P<0.05),immune performance(Χ~2=20.304,P<0.05),other serological evidence(Χ~2=14.150,P<0.05)in the number of cases occurred was higher than that in the control group;The main diagnostic conditions in the delayed diagnosis group may be lower than those in the control group due to positive IE on echocardiography(Χ~2=39.567,P<0.05)。Neglect of fever(Χ~2=0.3445,P>0.05)and blood bacteriological culture for IE positive indication(Χ~2=0.013,P>0.05)No statistical difference was found between the two groups.Conclusion:The clinical manifestations of IE exhibit diverse characteristics.In differential diagnosis,the ability of the main diagnostic criteria to indicate IE positivity should be improved,and sufficient vigilance should be given to secondary diagnostic criteria that are easily overlooked to prevent delayed diagnosis.