Van Camp Guy, Beles Monika, Penicka Martin, Schelfaut Dan, Wouters Stijn, De Raedt Herbert, Wyffels Eric, Spapen Jerrold, Nasser Riwa, Balogh Zsuzsanna, Albano Marzia, De Beenhouwer Hans, Van Vaerenbergh Kristien, Van Praet Frank, Degrieck Ivan, Stockman Bernard, Casselman Filip, Collet Carlos
Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium.
Gottsegen Gyorgy National Institute of Cardilogy, Haller u. 29, 1096 Budapest, Hungary.
J Clin Med. 2021 Aug 26;10(17):3832. doi: 10.3390/jcm10173832.
To investigate the value of prospective in-hospital registry data and the impact of an infectious endocarditis heart team approach (IEHT) on improvement in quality of care and monitor outcomes in hospitalized patients with IE.
Between December 2014 and the end of 2019, 160 patients were hospitalized in one centre with the definite diagnosis of infectious endocarditis (IE) and entered in a prospective registry. From 2017, an IEHT was introduced. Propensity score matching was used to assess the impact of an IEHT approach on clinical outcomes.
Median age was 72.5 y (62.75-80.00), diabetes was present in 33.1%, chronic kidney disease in 27.5%, COPD in 17.5%, and a history of ischaemic heart disease in 30.6%. Prosthetic valve IE was observed in 43.8% and device-related IE in 16.9% of patients. Staphylococcus (37.5%) was the most frequent pathogen followed by streptococcus (24.4%) and enterococcus (23.1%). Overall, 30-day and 1-year mortality were 19.4% and 37.5%, respectively. The introduction of prospective data collection and IE heart team was associated with a trend towards reduction of adjusted 1-year mortality (26.5% IEHT vs. 41.2% controls, = 0.0699). An IEHT clinical decision-making approach was independently associated with a shorter length of stay ( = 0.04).
Use of a prospective registry of IE coupled with a heart team approach was associated with more efficient patient management and a trend towards lower mortality. Prospective data collection and dedicated IEHT have the potential to improve patient care and clinical outcomes.
探讨前瞻性住院登记数据的价值以及感染性心内膜炎心脏团队方法（IEHT）对改善住院感染性心内膜炎（IE）患者护理质量和监测结局的影响。
2014年12月至2019年底，160例在一个中心确诊为感染性心内膜炎（IE）的患者住院并纳入前瞻性登记研究。从2017年起引入IEHT。采用倾向评分匹配法评估IEHT方法对临床结局的影响。
中位年龄为72.5岁（62.75 - 80.00岁），33.1%的患者患有糖尿病，27.5%患有慢性肾脏病，17.5%患有慢性阻塞性肺疾病，30.6%有缺血性心脏病史。43.8%的患者观察到人工瓣膜IE，16.9%为与器械相关的IE。葡萄球菌（37.5%）是最常见的病原体，其次是链球菌（24.4%）和肠球菌（23.1%）。总体而言，30天和1年死亡率分别为19.4%和37.5%。前瞻性数据收集和IE心脏团队的引入与调整后1年死亡率降低的趋势相关（IEHT组为26.5%，对照组为41.2%，P = 0.0699）。IEHT临床决策方法与住院时间缩短独立相关（P = 0.04）。
使用IE前瞻性登记研究结合心脏团队方法与更有效的患者管理以及死亡率降低趋势相关。前瞻性数据收集和专门的IEHT有改善患者护理和临床结局的潜力。
