Abstract：
Infective endocarditis (IE) is a highly fatal disease in cases of delayed diagnosis and treatment, although its incidence is low. However, there have been few single-center studies in which the risk of in-hospital death from IE was stratified according to laboratory findings on admission and the organism responsible for IE. In this study, a total of 162 patients who were admitted to our hospital during the period from 2009 to 2021, who were suspected of having IE according to the modified Duke classification, and for whom IE was confirmed by transesophageal echocardiography were retrospectively analyzed. Patients were observed for a mean-period of 43.7 days with the primary endpoint being in-hospital death. The in-hospital death group had a lower level of hemoglobin (Hb), higher white blood cell (WBC) count, lower level of estimated glomerular filtration rate (eGFR), and higher frequency of Staphylococcus being the causative agent than those in the non-in-hospital death group. In overall multivariate analysis, Hb, WBC count, eGFR, and Staphylococcus as the causative agent were identified to be significant prognostic determinants. IE patients with Hb < 10.6 g/dL, WBC count > 1.4 × 104/μL, eGFR < 28.1 mL/minute/1.7 m2, and Staphylococcus as the causative agent had significantly and synergistically increased in-hospital death rates compared to those in other IE patients. Low level of Hb, high WBC count, low eGFR, and Staphylococcus as the causative agent of IE were independent predictors of in-hospital mortality, suggesting that these 4 parameters may be combined to additively stratify the risk of in-hospital mortality.
摘要：
感染性心内膜炎（IE）是一种高度致命的疾病，在延误诊断和治疗的情况下，虽然发病率较低。然而,很少有单中心研究根据入院时的实验室结果和导致IE的机体对IE的院内死亡风险进行分层.在这项研究中,在2009年至2021年期间，共有162名患者入院，根据修改后的Duke分类，这些患者被怀疑患有IE，对经食管超声心动图确诊为IE的患者进行回顾性分析。观察患者的平均时间为43.7天，主要终点为住院死亡。住院死亡组的血红蛋白（Hb）水平较低，较高的白细胞（WBC）计数，较低水平的估计肾小球滤过率(eGFR)，葡萄球菌是病原体的频率高于非住院死亡组。在总体多变量分析中，Hb,白细胞计数,eGFR,和葡萄球菌作为病原体被确定为重要的预后决定因素。Hb<10.6g/dL的IE患者，白细胞计数>1.4×104/μL,eGFR<28.1mL/min/1.7m2,与其他IE患者相比,作为病原体的葡萄球菌具有显著且协同增加的院内死亡率。Hb水平低,白细胞计数高,eGFR低,葡萄球菌作为IE的致病因子是院内死亡率的独立预测因子，提示这4个参数可以结合起来对院内死亡风险进行相加分层.
