Impact of multidisciplinary Endocarditis Team on management of infective endocarditis.

Details

Serval ID
serval:BIB_3FEE08E1F48C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of multidisciplinary Endocarditis Team on management of infective endocarditis.
Journal
The Brazilian journal of infectious diseases
Author(s)
Fourré N., Zimmermann V., Guery B., Ianculescu N., Tozzi P., Kirsch M., Monney P., Papadimitriou-Olivgeris M.
ISSN
1678-4391 (Electronic)
ISSN-L
1413-8670
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Infective Endocarditis (IE) is a complex, life-threatening disease. The aim of the present study was to evaluate the impact of the Endocarditis-Team on management of IE. This observational study conducted at a university hospital (2015‒22), included adult patients with IE. The study period was divided in two periods: before (pre-Endocarditis-Team; pre-ET) and after the establishment of the Endocarditis-Team (post-Endocarditis-Team; post-ET) on January 2018. Among 505 IE episodes (187 in pre-Endocarditis-Team, 318 in post-ET period), <sup>18</sup> F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography was more commonly used in post-ET period (14 % vs. 28 %; p < 0.001). Overall, thirty-day and one-year mortality were 14 % and 27 %, respectively; no difference was observed between the two periods. In post-ET period, the administration of 4-weeks, rather than 6-weeks, of intravenous antimicrobial treatment was higher than in the post-ET period (15 % vs. 45 %; p < 0.001). Indication for surgery was present in 115 (61 %) patients in pre-ET and in 153 (48 %) in the post-ET period. In post-ET period, among patients with indication, valve surgery was more frequently performed (66 % vs. 78 %; p = 0.038). Such difference was due to a higher acceptance of operative indication by the cardiac surgeon (69 % vs. 94 %; p = 0.013). The observed increase in number of patients benefiting from cardiac surgery in the post-ET period led to a decrease of subsequent embolic events, since among patients with operative indication (n = 268), new embolic events after the establishment of the indication were more common in the pre-ET period compared to post-ET (23 % vs. 12 %; p = 0.033). After the implementation of the multidisciplinary Endocarditis-Team we observed several improvements in the general management of IE patients.
Keywords
(18)F-FDG PET/CT, Embolic events, Endocarditis-Team, Infective endocarditis, Multidisciplinary management, Valve surgery
Pubmed
Open Access
Yes
Create date
30/09/2024 13:34
Last modification date
01/10/2024 7:09
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