Utjecaj prethodne terapije statinima na ishod liječenja u bolesnika s infektivnim endokarditisom

master's thesis

• Title (english): The impact of prior statin therapy on the outcome of treatment in patients with infective endocarditis
• Author: Miroslav Ćaćić
• Mentor: Marija Santini (mentor)
• Committee member: Bruno Baršić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Marija Santini (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Uvod: Smrtnost infektivnog endokarditisa je visoka usprkos antimikrobnim lijekovima, stoga se ispituju imunomodulatorni lijekovi, između ostalih i statini. ----- Cilj: Pokazati imaju li bolesnici prethodno liječeni statinima lakši klinički oblik, manju učestalost SŽS komplikacija i manju smrtnost od infektivnog endokarditisa. ----- Ustroj: Retrospektivno kohortno, opservacijsko istraživanje, usporedba prethodno liječenih i prethodno neliječenih statinima. Mjesto: „Klinika za infektivne bolesti Dr. Fran Mihaljević”, Zagreb. Vrijeme: 2008. do 2012 godina. Ispitanici: Sepsa iz opće populacije, bakterijski izolat iz hemokultura, dob ≥ 50 god. Varijable ishoda: Potvrđena dijagnoza infektivnog endokarditisa, SOFA, učestalost komplikacija središnjeg živčanog sustava i mortalitet. ----- Rezultati: Uključeno 1161 pacijenata, 164 (14.1%) prethodno liječenjo statinima. Od svih pacijenata koji prethodno nisu uzimali statine, 95/997 (9.5%) pacijenata je imalo potvrđenu dijagnozu infektivnog endokarditisa, dok od svih pacijenata koji su prethodno uzimali statinsku terapiju, 27/164 (16.4%) pacijenata je imalo potvrđenu dijagnozu infektivnog endokarditisa (p=0.007). Medijan SOFA skora u onima prethodno neliječenima iznosio je 3.1 dok je u liječenih iznosio 2.6 (p=0.092). Učestalost SŽS komplikacija u prethodno liječenih statinima bila je 29.6%, dok je u neliječenih ona iznosila 32.6% (p=0.797). Mortalitet u prethodno neliječenih statinima iznosio je 15.8%, dok je u prethodno liječenih on 22.2% (p=0.56). ----- Zaključak: Nema statistički značajne razlike u težini kliničke slike, učestalosti SŽS komplikacija kao ni u smrtnosti od infektivnog endokarditisa između bolesnika prethodno liječenih i prethodno neliječenih statinima.

Abstract (english)

Introduction: Infective endocarditis mortality is high despite antimicrobial drugs, therefore immunomodulatory drugs are being investigated. ----- Objective: To show whether patients with prior statin therapy had less severe clinical presentation, lower rate of CNS complications, and lower mortality. ----- Design: Retrospective, cohort, observational study, comparing patients with and without prior statin therapy. Location: University Hospital for Infectious Diseases „Dr. Fran Mihaljević”, Zagreb. Time: five – year period (2008-2012) Patients: Community-acquired sepsis, age ≥ 50 years, bacterial isolate from blood cultures. Outcome variables: Positive bacterial isolate from blood cultures, SOFA, incidence of CNS complications and mortality. ----- Results: 1161 patients included, 164 (14.1%) with prior statin therapy. Infective endocarditis was diagnosed in 95 (9.5%) patients in non-statin group and in 27 (16.4%) patients in statin group (p=0.007). Median SOFA score in previously untreated 3.1, where in treated 2.6 (p=0.092). Incidence of CNS complications was 29.6% in previously treated, where in previously untreated it was 32.6% (p=0.797). In hospital mortality was 15.8% in prior statin non users, and 22.2% in prior statin users (p=0.56). ----- Conclusion: There are no statistically significant differences in severity, incidence of CNS complications and mortality of infective endocarditis in patients with and without prior statin therapy.

• Keywords: infektivni endokarditis; statini; SOFA score; SŽS komplikacije; mortalitet
• Keywords (english): infective endocarditis; statins; SOFA score; CNS complications; mortality
• Language: croatian
• URN:NBN: urn:nbn:hr:105:084633
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-04 09:06:04