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Addition of endocarditis team improves care at French hospital
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A hospital in France saw significant reductions in surgical delay, length of in-hospital stays and antibiotic therapy after establishing a multidisciplinary endocarditis team, according to results from an observational study.
“The epidemiology of infective endocarditis (IE) has changed in the previous decades.
Despite the constant evolution in antibiotic regimens, the prognosis of IE remains poor, with the in-hospital mortality ranging from 15% to 22%,” Yvon Ruch, MD, of the infectious and tropical disease service at Strasbourg University Hospital in Strasbourg, France, and colleagues wrote. “Although surgery is required for approximately half of the patients, its indications and timing in certain situations are unclear. Furthermore, diagnosis may be challenging, especially in cases with prosthetic valve endocarditis.”
Ruch and colleagues conducted an observational study at Strasbourg University Hospital between 2012 and 2017, examining in-hospital mortality and 6-month and 1-year mortality, surgery rate, time to surgical procedure, duration of effective antibiotic therapy and length of in-hospital stay.
Following guidelines issued by the American Heart Association and the European Society of Cardiology, the hospital established an endocarditis team in 2016 comprised of cardiac surgeons, cardiologists, echocardiographers and infectious disease specialists who meet weekly to discuss the diagnosis and management of endocarditis cases, according to the researchers.
In total, 391 episodes of IE were analyzed. Following implementation of the endocarditis team, the researchers found there was a nonsignificant decrease in in-hospital mortality, from 20.3% to 14.7%, along with a significant reduction in time to surgery, 16.4 to 10.3 days, respectively. Additionally, they noted a decrease in duration of antibiotic therapy, 55.2 vs. 47.2 days, and length of in-hospital stay, 40.6 vs. 31.9 days, according to the study.
“Currently, the prognosis of IE remains poor despite the documented therapeutic progress,” they wrote. “However, the establishment of an [endocarditis team] — which can be further optimized — provides additional leverage to improve the management of this disease. Further prospective studies are warranted to evaluate and promote this multidisciplinary approach.” – by Caitlyn Stulpin
Disclosures: The authors report no relevant financial disclosures.
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