Pulmonary complications observed in patients with infective endocarditis with and without injection drug use: An analysis of the National Inpatient Sample.
Pulmonary complications observed in patients with infective endocarditis with and without injection drug use: An analysis of the National Inpatient Sample.
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DOI：
10.1371/journal.pone.0256757
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Long JM
中科院分区：
文献类型：
--
作者：
Bui JT;Schranz AJ;Strassle PD;Agala CB;Mody GN;Ikonomidis JS;Long JM
心血管和神经系统并发症对感染性心内膜炎(IE)的影响已有很好的研究，但IE肺部并发症的发生率和意义尚不明确。为了更好地描述IE管理的多面性，我们的目标是描述IE肺部并发症的发生和意义，包括与药物使用相关的IE患者。在2016年全国住院患者样本中，使用≥-10代码识别了被诊断为IE的成年(18岁)患者的住院情况。多变量Logistic和线性回归用于比较有和无肺部并发症的IE患者的预后，并确定肺部并发症的预测因素。使用交互作用术语评估药物使用IE(DU-IE)和肺部并发症对住院结果的影响。2016年，估计有88,995名被诊断为IE的患者住院。在这些住院治疗中，15,490人(17%)与药物使用有关。吸毒型IE(DU-IE)的肺部并发症发生率最高(OR2.97，95%CI 2.50，3.45)。在6,580名(7%)IE患者中，至少发现了一种肺部并发症。DU-IE住院患者更有可能被诊断为脓胸(3%对1%，p<；0.001)、肺脓肿(3%对1%，p<；0.001)和败血症肺栓塞(27%对2%，p<；0.001)。肺部并发症与较长的平均住院时间(CIE 7.22天，95%CI 6.11，8.32)，较高的住院费用(CIE 78.51,000美元，95%CI 57.44，99.57)，更频繁的出院后转院(急性护理：OR 1.37，95%CI 1.09，1.71；长期护理：OR 2.19，95%CI 1.83，2.61)以及住院死亡率的增加(OR 1.81 95%CI 1.39，2.35)有关。合并肺部并发症的IE预后较差。DU-IE患者肺部并发症的发生率特别高，可能需要及时的胸部手术治疗，可能是由于右侧瓣膜受累。需要更多的研究来确定并发症的最佳管理策略，以改善患者的预后。
The impact of cardiovascular and neurologic complications on infective endocarditis (IE) are well studied, yet the prevalence and significance of pulmonary complications in IE is not defined. To better characterize the multifaceted nature of IE management, we aimed to describe the occurrence and significance of pulmonary complications in IE, including among persons with IE related to drug use. Hospitalizations of adult (≥18 years old) patients diagnosed with IE were identified in the 2016 National Inpatient Sample using ICD-10 codes. Multivariable logistic and linear regression were used to compare IE patient outcomes between those with and without pulmonary complications and to identify predictors of pulmonary complications. Interaction terms were used to assess the impact of drug-use IE (DU-IE) and pulmonary complications on inpatient outcomes. In 2016, there were an estimated 88,995 hospitalizations of patients diagnosed with IE. Of these hospitalizations,15,490 (17%) were drug-use related. Drug-use IE (DU-IE) had the highest odds of pulmonary complications (OR 2.97, 95% CI 2.50, 3.45). At least one pulmonary complication was identified in 6,580 (7%) of IE patients. DU-IE hospitalizations were more likely to have a diagnosis of pyothorax (3% vs. 1%, p<0.001), lung abscess (3% vs. <1%, p<0.001), and septic pulmonary embolism (27% vs. 2%, p<0.001). Pulmonary complications were associated with longer average lengths of stay (CIE 7.22 days 95% CI 6.11, 8.32), higher hospital charges (CIE 78.51 thousand dollars 95% CI 57.44, 99.57), more frequent post-discharge transfers (acute care: OR 1.37, 95% CI 1.09, 1.71; long-term care: OR 2.19, 95% CI 1.83, 2.61), and increased odds of inpatient mortality (OR 1.81 95% CI 1.39, 2.35). IE with pulmonary complications is associated with worse outcomes. Patients with DU-IE have a particularly high prevalence of pulmonary complications that may require timely thoracic surgical intervention, likely owing to right-sided valve involvement. More research is needed to determine optimal management strategies for complications to improve patient outcomes.
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DOI：
10.6061/clinics/2016(10)02
发表时间：
2016-10-01
期刊：
Clinics (Sao Paulo, Brazil)
影响因子：
--
作者：
Chou DW;Wu SL;Chung KM;Han SC;Cheung BM
通讯作者：
Cheung BM
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
81.5
作者：
Holland, Thomas L.;Baddour, Larry M.;Fowler, Vance G., Jr.
通讯作者：
Fowler, Vance G., Jr.
影响因子：
158.5
作者：
Rahman, Najib M.;Maskell, Nicholas A.;Davies, Robert J. O.
通讯作者：
Davies, Robert J. O.
DOI：
10.2174/1874306401408010028
发表时间：
2014-01-01
期刊：
The open respiratory medicine journal
影响因子：
--
作者：
Goswami, Umesh;Brenes, Jorge A;Williams, David N
通讯作者：
Williams, David N