Survival of Surgically Treated Infective Endocarditis: A Comparison With the General Dutch Population
Survival of Surgically Treated Infective Endocarditis: A Comparison With the General Dutch Population
复制标题
DOI：
10.1016/j.athoracsur.2011.02.007
复制
发表时间：
2011-05-01
影响因子：
4.6
通讯作者：
Bogers, Ad J. J. C.
中科院分区：
文献类型：
--
作者：
Mokhles, M. Mostafa;Ciampichetti, Isabella;Bogers, Ad J. J. C.
背景资料。感染性心内膜炎(IE)仍然与较高的住院和长期死亡率有关。通过与年龄匹配和性别匹配的普通人群进行比较，从未正确看待接受手术的IE患者的结果。本研究的目的是评估接受手术的IE患者的长期死亡率与年龄匹配和性别匹配的普通人群的关系。对1998-2007年间连续手术的138例IE患者进行了回顾性观察队列研究。累积生存率采用Kaplan-Meier方法进行分析。患者生存期与普通人群的比较是使用荷兰人口生命表进行的。用标化死亡率来评估晚期死亡的程度。观察到的住院死亡风险为10.9%。术后1、5、10年的长期生存率分别为85%(95%可信区间，78%~90%)、74%(95%可信区间，65%~79%)、71%(95%可信区间，62%~78%)。在经过1年、5年和10年的随访期后，普通人群中年龄匹配和性别匹配的存活率分别为99%、93%和80%。标化死亡率为0.99(95%可信区间为0.67~1.31)。尽管术后即刻IE患者的死亡率仍然很高，但随着随访时间的增加，医院幸存者的死亡率与普通人群相当。
Background. Infective endocarditis (IE) remains associated with high in-hospital and long-term mortality. The outcome of patients with IE who are operated on has never been put into perspective by comparing it to the age-matched and gender-matched general population. The aim of the present study was to evaluate the long-term mortality of patients with IE who undergo operation in relation to the age-matched and gender-matched general population.Methods. A retrospective observational cohort study of 138 patients with IE who underwent consecutive operations (1998-2007) was conducted. Cumulative survival was analyzed using the Kaplan-Meier method. Comparison of patient survival with the general population was done using the Dutch population life table. The standardized mortality ratio was used to assess the degree of late deaths.Results. The observed in-hospital mortality risk was 10.9%. The observed long-term survival was 85% (95% confidence interval, 78% to 90%), 74% (95% confidence interval, 65% to 79%), 71% (95% confidence interval, 62% to 78%) after 1, 5, and 10 years, respectively. Age-matched and gender-matched survival in the general population was 99%, 93%, and 80% after a follow-up period of 1, 5, and 10 years, respectively. The standardized mortality ratio was 0.99 (95% confidence interval, 0.67 to 1.31).Conclusions. Although mortality of IE patients who have undergone operation remains considerable during the immediate postoperative period, the mortality of hospital survivors is, with increasing follow-up time, comparable with the general population.