JACC. Advances · 2026
Evolution of Management and Outcomes of Infective Endocarditis After Introducing the Endocarditis Team.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dalebout Eefje M, Budde Ricardo P J, Galema Tjebbe W, Wahadat Ali R, Swart Laurens E, Veen Kevin M, Verkaik Nelianne J, Hirsch Alexander, Kluin Jolanda, Roos-Hesselink Jolien W
Аннотация
BACKGROUND: Current guidelines recommend discussing patients with infective endocarditis in an endocarditis team (ET). The benefits of an ET have been established, but not the evolution over time.
OBJECTIVES: The objective of the study was to investigate changes in management and outcomes in infective endocarditis over time.
METHODS: All patients discussed by our ET since 2016 were prospectively included and divided into 3 cohorts. Trends over time for the number of discussions, diagnostics, ET recommendations, treatment, and outcomes were assessed using Poisson, logistic, and Cox regression, respectively, adjusted for potential case mix.
RESULTS: The total cohort included 1,042 patients, with 223, 364, and 455 patients in cohorts 1 (2016-2018), 2 (2019-2021), and 3 (2022-2024), respectively. The percentage of patients with a rediscussion increased with 18.2% (P < 0.001), and the number of discussions per patient increased with 3% per diagnosis-year (P = 0.006). The percentage of patients with positive blood cultures decreased with 17.5% (P < 0.001), whereas cardiac computed tomography (CT) and positron emission tomography (PET) CT usage increased with 3.1% (P = 0.028) and 12.5% (P < 0.001), respectively. Advice for additional diagnostic tests decreased by 11.6% (P < 0.001), and treatment change decreased by 18.3% (P < 0.001). Reclassification of the initial diagnosis increased with 8.3% (P = 0.045). Relapse (P = 0.82) and reinfection rates did not change (P = 0.98). One-year survival was approximately 80% and remained stable (P = 0.62).
CONCLUSIONS: There were more referrals and rediscussions, but less need for additional advice, reflecting increased familiarity with and a learning effect of the ET. CT and PET-CT were used more often. Mortality did not change over time and remained high.
OBJECTIVES: The objective of the study was to investigate changes in management and outcomes in infective endocarditis over time.
METHODS: All patients discussed by our ET since 2016 were prospectively included and divided into 3 cohorts. Trends over time for the number of discussions, diagnostics, ET recommendations, treatment, and outcomes were assessed using Poisson, logistic, and Cox regression, respectively, adjusted for potential case mix.
RESULTS: The total cohort included 1,042 patients, with 223, 364, and 455 patients in cohorts 1 (2016-2018), 2 (2019-2021), and 3 (2022-2024), respectively. The percentage of patients with a rediscussion increased with 18.2% (P < 0.001), and the number of discussions per patient increased with 3% per diagnosis-year (P = 0.006). The percentage of patients with positive blood cultures decreased with 17.5% (P < 0.001), whereas cardiac computed tomography (CT) and positron emission tomography (PET) CT usage increased with 3.1% (P = 0.028) and 12.5% (P < 0.001), respectively. Advice for additional diagnostic tests decreased by 11.6% (P < 0.001), and treatment change decreased by 18.3% (P < 0.001). Reclassification of the initial diagnosis increased with 8.3% (P = 0.045). Relapse (P = 0.82) and reinfection rates did not change (P = 0.98). One-year survival was approximately 80% and remained stable (P = 0.62).
CONCLUSIONS: There were more referrals and rediscussions, but less need for additional advice, reflecting increased familiarity with and a learning effect of the ET. CT and PET-CT were used more often. Mortality did not change over time and remained high.