AI Article Synopsis
- The study investigates the prognosis of patients with infective endocarditis (IE) based on their healthcare pathway and the application of ESC guidelines in their treatment.
- Conducted in 22 hospitals in South-East France, the research involved 342 patients divided into three groups: those treated entirely in referral centers, those initially treated in non-referral centers then referred, and those entirely treated in non-referral centers.
- Results showed a one-year mortality rate of 26%, with significantly higher mortality (37%) for patients treated solely in non-referral centers compared to those in referral and transferred centers, indicating that healthcare pathway significantly impacts patient outcomes.*
Article Abstract
Aims: To determine the prognosis of patients treated for infective endocarditis (IE) according to their healthcare pathway. To assess how the ESC guidelines are implemented concerning the performance of transoesophageal echocardiography, the use of antibiotic therapy, and the performance of valve surgery; and to compare the epidemiological profile of IE according to the type of centres in which the patients are hospitalized.
Methods And Results: In a prospective multicentric study including 22 hospitals in the South-East of France, 342 patients were classified into three groups according to their healthcare pathway: 119 patients diagnosed and taken care entirely in a reference centre or hospital with cardiac surgery [Referral Center (RC) group], 111 patients diagnosed and initially taken care in a non-RC (NRC), then referred in a centre including cardiac surgery [transferred to the Referral Center (TRC) group] and 112 patients totally taken care in the NRC (NRC group). One-year mortality was 26% (88 deaths) and was not significantly different between Groups 1 and 2 (20 vs. 21%, P = 0.83). Patients in the NRC group had a higher mortality (37%) compared with patients in the RC and TRC groups (P < 0.001). ESC guidelines were not implemented similarly depending on the healthcare pathway (P = 0.04). Patients in the NRC group were significantly older (P < 0.001) and had more comorbidities (P < 0.001) than patients treated in referral centres.
Conclusion: Prognosis of patients with IE is influenced by their healthcare pathway. Patients treated exclusively in NRC have a worse prognosis than patients treated in referral or surgical centres.
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| http://dx.doi.org/10.1093/ehjacc/zuac088 | DOI Listing |
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