摘要
Abstract
Objective To analyze the clinical characteristics and factors influencing short-term prognosis in elderly patients with infective endocarditis(IE)at a tertiary hospital in Zhumadian.Methods A total of 92 patients with IE who were admitted to Zhumadian Central Hospital from January 2020 to August 2024 were retrospectively selected.All patients were followed up for 6 months after completing treatment.Based on the prognosis,they were divided into the poor prognosis group(experiencing death,IE recurrence,recurrent embolism,heart failure,etc.n=32)and the good prognosis group(no adverse events mentioned above,n=60).General clinical data,clinical characteristics,and pathogen distribution were compared between the two groups.Multivariate logistic regression was used to analyze factors influencing short-term prognosis in IE patients.Results Symptoms of the 92 elderly patients with IE was dominated by fever,accounting for 97.83％(90/92),followed by palpitation 40.22％(37/92),chest distress 28.26％(26/92),and fatigue 15.22％(14/92).A total of 55 patients(59.78％)had underlying cardiac comditions,including congenital heart disease(27/92,29.35％),rheumatic heart disease(15/92,16.30％),and history of cardiac surgery or interventional therapy(13/92,14.13％).Blood cultures were positive in 74 patients(82.61％),with Gram-positive bacteria identified in 56 cases(75.68％)and Gram-negative bacteria in 18 cases(24.32％).Compared to the good prognosis group,the poor prognosis group had significantly higher proportions of elevated neutrophil count,elevated white blood cell count,patients with NYHA(New York Heart Association)class Ⅳ heart function,patients with in-hospital complications,patients with serum albumin<30 g/L,and patients with hemoglobin<90 g/L.The proportion of patients who underwent valve replacement or valve repair was significantly lower in the poor prognosis group(P<0.05).Multivariate logistic regression analysis identified NYHA class Ⅳ heart function(OR=3.271,95％CI:1.578-6.781,P=0.002)and high neutrophil count(OR=1.219,95％CI:1.073-1.385,P=0.002)as independent risk factors for short-term prognosis in elderly IE patients.Conversely,receiving valve replacement or valve repair(OR=0.223,95％CI:0.102-0.486,P<0.001)and high hemoglobin levels(OR=0.196,95％CI:0.088-0.436,P<0.001)were identified as independent protective factors.Conclusions Elderly IE patients present with diverse clinical symptoms.Key factors influencing short-term prognosis include NYHA functional class,valve replacement or valve repair,and levels of hemoglobin and neutrophils.Close clinical monitoring of these indicators is recommended.关键词
感染性心内膜炎/临床特征/短期预后/影响因素Key words
infective endocarditis/clinical characteristic/short-term prognosis/influencing factors
