Original articleAdult cardiacThe Clinical Impact of Implementation of a Multidisciplinary Endocarditis Team
Section snippets
Team Protocol
The University of Michigan Multidisciplinary Endocarditis Team (MDET) was formed on May 3, 2018. Core group members participate on a voluntary basis. The MDET met weekly and developed an evidence-based institutional protocol for diagnosis as well as surgical and medical management of IE (Supplemental Figure).11, 12, 13 The algorithm was designed for use by both general practitioners and subspecialists and was approved by the Departments of Cardiac Surgery and Neurology as well as the Divisions
Study Population
Between June 14, 2018, and June 13, 2019, the MDET presented and provided recommendations for 119 inpatients with IE. Fifty-six of these patients had definite endocarditis with at least 1 AHA surgical indication. The remaining 63 cases were excluded from further analysis (Figure 1).
The characteristics of the patients in both cohorts are provided in Table 1. The mean age of patients managed by the MDET was 50.7 years and 62.5% were male. The average patient in the historical control was
Comment
Our retrospective study demonstrated a significant improvement in the rate of in-hospital mortality for patients with definite endocarditis and indications for surgical intervention after implementation of a multidisciplinary endocarditis team. Mortality for medically managed patients also improved significantly. There was a nonsignificant increase in the proportion of patients undergoing surgical valve replacement after implementation of MDET. The post-MDET period also demonstrated a dramatic
References (24)
- et al.
Impact of early surgery on 6-month outcome in acute infective endocarditis
Int J Cardiol
(2008) - et al.
Influence of a multidisciplinary alert strategy on mortality due to left-sided infective endocarditis
Rev Esp Cardio
(2014) - et al.
Outcome of vancomycin treatment in patients with methicillin-susceptible Staphylococcus aureus bacteremia
Antimicrob Agents Chemother
(2007) - et al.
Infective endocarditis in the U.S., 1998-2009: a nationwide study
PLOS ONE
(2013) - et al.
Long-term outcome of infective endocarditis: the impact of early surgical intervention
Clin Infect Dis
(2001) - et al.
Early surgery versus conventional treatment for infective endocarditis
N Engl J Med
(2012) - et al.
Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the international collaboration on endocarditis
Circulation
(2014) - et al.
Dramatic reduction in infective endocarditis-related mortality with a management-based approach
Arch Intern Med
(2009) - et al.
Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol
J Cardiovasc Med
(2013) - et al.
Impact of the duration of antibiotic therapy on relapse and survival following surgery for active infective endocarditis
Eur J Cardiothorac Surg
(2019)
Impact of setting up an “endocarditis team” on the management of infective endocarditis
Open Forum Infec Dis
2015 ESC guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)
Eur Heart J
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