https://scholars.lib.ntu.edu.tw/handle/123456789/560008
標題: | Clinical experience of infective endocarditis complicated by acute cerebrovascular accidents | 作者: | Hsu C.-Y. NAI-HSIN CHI SHOEI-SHEN WANG YIH-SHARNG CHEN HSI-YU YU |
公開日期: | 2017 | 出版社: | Elsevier (Singapore) Pte Ltd | 卷: | 40 | 期: | 2 | 起(迄)頁: | 100-105 | 來源出版物: | Asian Journal of Surgery | 摘要: | Background/Objective To evaluate the clinical results of patients with infective endocarditis (IE) complicated by acute cerebrovascular accidents (CVAs). Methods A total of 44 patients with IE complicated by CVA at admission were retrospectively analyzed in a single medical institute from 2005 to 2011. At the time of admission, 18 patients were diagnosed with hemorrhagic stroke, and 26 patients were diagnosed with ischemic stroke. Fifteen patients received surgical intervention during hospitalization. Results The hospital mortality rate was 38.9% for the hemorrhagic stroke group and 42.3% for the ischemic stroke group (p?=?0.821). The mortality rate was 33.3% for the surgical group and 44.8% for the nonsurgical group (p?=?0.531). At 30 days of hospitalization, 45.8% of the patients experienced an adverse event (defined as death due to organ failure, restroke, cardiogenic shock, or septic shock during the treatment period), and the attrition rate was 1.5% per day. Surgery performed after the adverse events increased mortality (80.0%) compared with surgery performed on patients with no adverse events (10.0%; p?=?0.017). A Cox regression analysis revealed that creatinine > 2?mg/dL, diabetes, and staphylococcal infection were the risk factors of the adverse events. Conclusion Early surgical intervention for IE with ischemic stroke may prevent adverse events, particularly in patients with impaired renal function, diabetes, or staphylococcal infection. A delay in operation of > 30 days is recommended after hemorrhagic stroke. ? 2017 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84947599560&doi=10.1016%2fj.asjsur.2015.10.001&partnerID=40&md5=fc12a4bfdf067c1fd66ed230ca0d2553 https://scholars.lib.ntu.edu.tw/handle/123456789/560008 |
ISSN: | 1015-9584 | DOI: | 10.1016/j.asjsur.2015.10.001 | SDG/關鍵字: | adult; aged; cerebrovascular accident; chi square distribution; cohort analysis; comparative study; complication; endocarditis; evaluation study; female; heart valve replacement; hospital mortality; hospitalization; human; Kaplan Meier method; male; middle aged; mortality; neurosurgery; nonparametric test; pathology; procedures; proportional hazards model; retrospective study; risk assessment; severity of illness index; statistics and numerical data; survival analysis; Taiwan; treatment outcome; Adult; Aged; Chi-Square Distribution; Cohort Studies; Endocarditis; Female; Heart Valve Prosthesis Implantation; Hospital Mortality; Hospitalization; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neurosurgical Procedures; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric; Stroke; Survival Analysis; Taiwan; Treatment Outcome |
顯示於: | 醫學系 |
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