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. 2023 Jan;31(1):29-35.
doi: 10.1007/s12471-022-01707-6. Epub 2022 Jul 4.

The impact of the multidisciplinary Endocarditis Team on the management of infective endocarditis

A R Wahadat  1   2   3 , W Tanis  3 , T W Galema  1 , L E Swart  1   2 , W J van Leeuwen  4 , N J Verkaik  5 , C A M Schurink  5   6 , B van Dalen  7 , S Zoet-Nugteren  8 , C Gurlek  9 , R P J Budde  2 , J W Roos-Hesselink  10
Affiliations

The impact of the multidisciplinary Endocarditis Team on the management of infective endocarditis

A R Wahadat et al. Neth Heart J. 2023 Jan.

Abstract

Background: In their latest guidelines for infective endocarditis (IE) (2015), the European Society of Cardiology (ESC) introduced the implementation of the Endocarditis Team (ET) to facilitate the management of IE. This study presents our experiences and the diagnostic and therapeutic impact of the ET on the management of IE.

Methods: From 2016-2020, data of all patients with suspected IE referred to the ET were prospectively collected. The final diagnosis was defined by the ET as either rejected, possible or definite IE. Diagnostic impact was scored as any change in initial diagnosis, the frequency of additional diagnostic tests advised by the ET and any change in diagnosis after these tests. Therapeutic impact was scored as any change in antibiotic therapy or change from conservative to invasive therapy or vice versa.

Results: A total of 321 patients (median age 67 [55-77] years, 71% male) were enrolled. The final diagnosis was rejected IE in 47 (15%), possible IE in 34 (11%) and definite IE in 240 (75%) patients. A change of initial diagnosis was seen in 53/321(17%) patients. Additional microbiological tests were advised in 69/321 (21%) patients, and additional imaging tests in 136/321 (42%) patients, which resulted in subsequent change in diagnosis in 23/321 (7%) patients. Any change in antibiotic treatment was advised in 135/321 (42%) patients, and change from initial conservative to additional surgical treatment in 15/321 (5%) patients.

Conclusion: The ET had a clear impact on the therapeutic policy for patients with suspected IE and is useful in the management of this life-threatening disease. Broad implementation is warranted.

Keywords: Infection; Infective endocarditis; Multidisciplinary care.

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Conflict of interest statement

A.R. Wahadat, W. Tanis, T.W. Galema, L.E. Swart, W.J. van Leeuwen, N.J. Verkaik, C.A.M. Schurink, B. van Dalen, S. Zoet-Nugteren, C. Gurlek, R.P.J. Budde and J.W. Roos-Hesselink declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overview of the results of 321 patients with suspected IE discussed in the Endocarditis Team. IE infective endocarditis
Fig. 2
Fig. 2
The survival curve of all discussed patients per group (a) and the patients with definite IE per category (b). IE infective endocarditis
Fig. 3
Fig. 3
The incidence curve for relapse/re-infection of all patients with possible and definite IE (a) and patients with definite IE per category (b). IE infective carditis
See this image and copyright information in PMC

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