Analysis Of Clinical Characteristics And Risk Factors In Patients With Infective Endocarditis Combined With Hypercoagulable State

Objective:This study retrospectively analyzed the clinical characteristics and risk factors of patients with infective endocarditis(IE)combined with hypercoagulable state,and investigated the potential risk factors for the occurrence of hypercoagulable state and the impact of hypercoagulability on the severity and prognosis of patients with infective endocarditis,in order to provide a partial theoretical basis for the clinical treatment and prognostic assessment of infective endocarditis.Methods:A total of 93 patients who were diagnosed with infectious endocarditis during hospitalization in a Grade-III hospital in Changchun City from September 2017 to September 2022 were selected as the study objects.A retrospective analysis was conducted on a total of 93 patients.The patients were divided into high coagulation group and non-high coagulation group according to whether they were combined with fibrinogen(Fib)and D-dimer(D-D)at admission.The general clinical data,infection and inflammation-related indexes,causative organisms and valve involvement,and prognosis of the two groups were compared to analyze the risk factors for infective endocarditis combined with hypercoagulable state and the effect of hypercoagulable state on the prognosis of patients with infective endocarditis.Results:1.A total of 93 patients were included in this study,including 59 males and 34 females,34 in the hypercoagulable group and 59 in the non-hypercoagulable group.There was a statistically significant difference between the hypercoagulation group and the non-hypercoagulation group in terms of age > 65 years,history of recent bed rest,history of diabetes mellitus,and history of cerebral infarction(P <0.05).There was no statistical significance between the two groups in terms of gender,history of smoking,history of alcohol consumption,history of hypertension,history of congenital heart disease,clinical manifestations(fever,chest tightness),and BMI(P >0.05).2.The comparison of infection and inflammation-related indicators between the high coagulation group and the non-high coagulation group showed that: Compared with non-hypercoagulant group,white blood cell count,neutrophil percentage,C-reactive protein and neutrophil to lymphocyte ratio in hypercoagulant group were significantly different(P < 0.05).However,there were no significant differences in platelet to lymphocyte ratio,mean platelet volume,albumin and preprotein levels(P > 0.05).3.In terms of the results of blood culture and the location and length of the growth,the positive rate of blood culture in the high coagulation group was higher than that in the non-high coagulation group(P < 0.05),but there was no statistical significance in the comparison of positive pathogenic bacteria and the location and length of the growth between the two groups(P > 0.05).4.In terms of complications,patients in the high coagulation group were more likely to have arterial embolism and venous thromboembolism events(P < 0.05);In addition,compared with the non-hypercoagulable group,patients in the hypercoagulable group had a longer hospital stay after surgery,a higher simplified risk score of Park LP model,which can be used for risk stratification,and a higher risk of death,with statistical significance(P < 0.05).5.Univariate Logistic regression analysis showed that: There were statistically significant differences between the two groups in age > 65 years old,history of diabetes,history of cerebral infarction,recent bed history,white blood cell count,percentage of neutrophil,ratio of neutrophil to lymphocyte,C-reactive protein,positive blood culture,and simplified risk score of Park LP model(P<0.05).There was no statistical significance in other indexes(P>0.05).Multivariate Logistic regression analysis showed that cerebral infarction history and C-reactive protein elevation were independent risk factors for IE combined with hypercoagulability(P<0.05).Conclusions:1.Compared with non-hypercoagulable patients,IE patients with hypercoagulable state have more severe infection,are more likely to have arterial embolism and venous thromboembolism events,have relatively more severe illness,have longer average hospital stay,and have a higher risk of death.2.In the present study,no correlation was found between the hypercoagulable state of IE patients and the pathogenic microorganisms and flabby features causing IE.3.History of cerebral infarction and elevated CRP are independent risk factors for hypercoagulable state in patients with IE.