The impact of establishing a regional infective endocarditis (IE) network on pre-operative IE-related complications and on post-operative outcome

Autor:	Karim Ibrahim, M W Pletz, S Hagel, Albrecht Guenther, Gloria Faerber, H Ebelt, M. Diab, Torsten Doenst, A. Struve, M Jahnecke, Paul Christian Schulze, Thomas Lehmann, H Kuehn, Thuringian endocarditis netowrk, H Sigusch, Marcus Franz
Rok vydání:	2021
Předmět:	medicine.medical_specialty business.industry Infective endocarditis Network on Medicine Post operative Cardiology and Cardiovascular Medicine business medicine.disease Outcome (game theory) Pre operative Surgery
Zdroj:	European Heart Journal. 42
ISSN:	1522-9645 0195-668X
Popis:	Background Infective endocarditis (IE) requires a high degree of suspicion and advanced level of multidisciplinary management. In 2015, the European guidelines recommended the formation of an endocarditis-team (ET) for optimal treatment of IE. In 2011, we already established an ET within the hospital that was only consulted on demand for certain patients. Since 2015, ET has been increasingly involved in the management of almost all patients with IE. In addition, we established in 2015 a statewide endocarditis- (E) network for the referring hospitals. Purpose We investigated the effect of E-network on reducing referral latency and pre-operative IE-related complications. We also investigated the adherence to the ET management recommendations in our hospital and its impact on post-operative stroke and mortality. Methods We retrospectively analyzed data from patients operated for IE in our center between 01/2007 and 03/2018. We conducted univariate analysis using Chi-square or Fisher's exact test, Multivariate logistic regression models for in-hospital mortality and post-operative stroke, and Kaplan-Meier estimate of 5-years survival. Results Among 630 patients operated for IE in our center, 409 (65%) underwent surgery in the 1st era before 12/2014. S. aureus IE was more frequent in the second era (34% vs 25%, p Conclusion Endocarditis-network led to earlier referral of patients, which resulted in less IE-related complications on admission. Lack of ET management recommendations was an independent predictor for post-operative stroke, in-hospital mortality and was associated with worse 5-years survival. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::c5545bf66d74b933202d90412ade9a4d https://doi.org/10.1093/eurheartj/ehab724.1721 Zobrazit plný text záznamu