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Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis

BACKGROUND: Infective endocarditis (IE) remains a severe disease with a high mortality rate. Therefore, guidelines encourage the setup of a multidisciplinary group in reference centers. The present study evaluated the impact of this “Endocarditis Team” (ET). METHODS: We conducted a monocentric obser...

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Autores principales: Ruch, Yvon, Mazzucotelli, Jean-Philippe, Lefebvre, François, Martin, Aurélie, Lefebvre, Nicolas, Douiri, Nawal, Riegel, Philippe, Hoang Minh, Tam, Petit-Eisenmann, Hélène, Hansmann, Yves, Argemi, Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735925/
https://www.ncbi.nlm.nih.gov/pubmed/31660397
http://dx.doi.org/10.1093/ofid/ofz308
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author Ruch, Yvon
Mazzucotelli, Jean-Philippe
Lefebvre, François
Martin, Aurélie
Lefebvre, Nicolas
Douiri, Nawal
Riegel, Philippe
Hoang Minh, Tam
Petit-Eisenmann, Hélène
Hansmann, Yves
Argemi, Xavier
author_facet Ruch, Yvon
Mazzucotelli, Jean-Philippe
Lefebvre, François
Martin, Aurélie
Lefebvre, Nicolas
Douiri, Nawal
Riegel, Philippe
Hoang Minh, Tam
Petit-Eisenmann, Hélène
Hansmann, Yves
Argemi, Xavier
author_sort Ruch, Yvon
collection PubMed
description BACKGROUND: Infective endocarditis (IE) remains a severe disease with a high mortality rate. Therefore, guidelines encourage the setup of a multidisciplinary group in reference centers. The present study evaluated the impact of this “Endocarditis Team” (ET). METHODS: We conducted a monocentric observational study at Strasbourg University Hospital, Strasbourg, France, between 2012 and 2017. The primary end point was in-hospital mortality. Secondary end points were 6-month and 1-year mortality, surgery rate, time to surgical procedure, duration of effective antibiotic therapy, length of in-hospital stay, and sequelae. We also assessed predictors of in-hospital mortality. RESULTS: We analyzed 391 episodes of IE. In the post-ET period, there was a nonsignificant decrease in in-hospital mortality (20.3% vs 14.7%, respectively; P = .27) and sequelae, along with a significant reduction in time to surgery (16.4 vs 10.3 days, respectively; P = .049), duration of antibiotic therapy (55.2 vs 47.2 days, respectively; P < .001), and length of in-hospital stay (40.6 vs 31.9 days, respectively; P < .01). In a multivariate analysis, the post-ET period was positively associated with survival (odds ratio, 0.45; 95% confidence interval, 0.20–0.96; P = .048). CONCLUSIONS: This multidisciplinary approach exerted a positive impact on the management of IE and should be considered in all hospitals managing IE.
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spelling pubmed-67359252019-09-16 Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis Ruch, Yvon Mazzucotelli, Jean-Philippe Lefebvre, François Martin, Aurélie Lefebvre, Nicolas Douiri, Nawal Riegel, Philippe Hoang Minh, Tam Petit-Eisenmann, Hélène Hansmann, Yves Argemi, Xavier Open Forum Infect Dis Major Article BACKGROUND: Infective endocarditis (IE) remains a severe disease with a high mortality rate. Therefore, guidelines encourage the setup of a multidisciplinary group in reference centers. The present study evaluated the impact of this “Endocarditis Team” (ET). METHODS: We conducted a monocentric observational study at Strasbourg University Hospital, Strasbourg, France, between 2012 and 2017. The primary end point was in-hospital mortality. Secondary end points were 6-month and 1-year mortality, surgery rate, time to surgical procedure, duration of effective antibiotic therapy, length of in-hospital stay, and sequelae. We also assessed predictors of in-hospital mortality. RESULTS: We analyzed 391 episodes of IE. In the post-ET period, there was a nonsignificant decrease in in-hospital mortality (20.3% vs 14.7%, respectively; P = .27) and sequelae, along with a significant reduction in time to surgery (16.4 vs 10.3 days, respectively; P = .049), duration of antibiotic therapy (55.2 vs 47.2 days, respectively; P < .001), and length of in-hospital stay (40.6 vs 31.9 days, respectively; P < .01). In a multivariate analysis, the post-ET period was positively associated with survival (odds ratio, 0.45; 95% confidence interval, 0.20–0.96; P = .048). CONCLUSIONS: This multidisciplinary approach exerted a positive impact on the management of IE and should be considered in all hospitals managing IE. Oxford University Press 2019-07-16 /pmc/articles/PMC6735925/ /pubmed/31660397 http://dx.doi.org/10.1093/ofid/ofz308 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Ruch, Yvon
Mazzucotelli, Jean-Philippe
Lefebvre, François
Martin, Aurélie
Lefebvre, Nicolas
Douiri, Nawal
Riegel, Philippe
Hoang Minh, Tam
Petit-Eisenmann, Hélène
Hansmann, Yves
Argemi, Xavier
Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title_full Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title_fullStr Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title_full_unstemmed Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title_short Impact of Setting up an “Endocarditis Team” on the Management of Infective Endocarditis
title_sort impact of setting up an “endocarditis team” on the management of infective endocarditis
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735925/
https://www.ncbi.nlm.nih.gov/pubmed/31660397
http://dx.doi.org/10.1093/ofid/ofz308
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