Valvular heart diseaseImpact of a Multidisciplinary Management Strategy on the Outcome of Patients With Native Valve Infective Endocarditis
Section snippets
Methods
From 1996 through 2009, 292 consecutive patients with definite NVE according to modified Duke criteria14 were identified at Ca' Foncello Hospital, Treviso, Italy. Clinical, microbiological, and imaging data were collected prospectively in a computerized database. Comorbidity was assessed by using the Charlson co-morbidity index.15 Each patient underwent ≥1 transthoracic and ≥transesophageal echocardiography (TEE) study. Three or more blood cultures were obtained from each patient. Delayed
Results
During the whole study period, 307 patients had NVE. After review of each case by 2 expert investigators, 15 cases were excluded for the following reasons: possible or rejected NVE (10) and incomplete case report form (5).The final sample was made up of 292 patients with definite NVE. One hundred two cases of NVE were included during period 1 (1996 through 2002), and 190 cases were included in period 2 (2003 through 2008), following the implementation of the management protocol. Comparing
Discussion
The present study demonstrates a significant reduction in NVE-related mortality since the inception of a formalized policy regarding the establishment of a multidisciplinary and coordinated approach to management, suggesting a beneficial impact of this strategy. Although it remains difficult to definitively demonstrate a direct relationship between the reduction in mortality and the use of our protocol, it seems unlikely that an intrinsic difference between the 2 patient populations can be
Disclosures
The authors have no conflicts of interest to disclose.
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