Journal of Clinical Medicine (Aug 2021)

Importance of In-Hospital Prospective Registry and Infectious Endocarditis Heart Team to Monitor and Improve Quality of Care in Patients with Infectious Endocarditis

  • Guy Van Camp,
  • Monika Beles,
  • Martin Penicka,
  • Dan Schelfaut,
  • Stijn Wouters,
  • Herbert De Raedt,
  • Eric Wyffels,
  • Jerrold Spapen,
  • Riwa Nasser,
  • Zsuzsanna Balogh,
  • Marzia Albano,
  • Hans De Beenhouwer,
  • Kristien Van Vaerenbergh,
  • Frank Van Praet,
  • Ivan Degrieck,
  • Bernard Stockman,
  • Filip Casselman,
  • Carlos Collet

DOI
https://doi.org/10.3390/jcm10173832
Journal volume & issue
Vol. 10, no. 17
p. 3832

Abstract

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Aim: 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. Methods: 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. Results: 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, p = 0.0699). An IEHT clinical decision-making approach was independently associated with a shorter length of stay (p = 0.04). Conclusions: 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.

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