Related Experiment Videos
The impact of a policy of collaborative management on mortality and morbidity from infective endocarditis
R J Bain1, D Glover, W A Littler
1Department of Cardiovascular Medicine, University of Birmingham, East Birmingham Hospital, U.K.
Insights
Collaborative management of endocarditis by a multidisciplinary team significantly reduced patient mortality from 34% to 24%. Early referral to this specialized team further decreased mortality to 6%, primarily by reducing deaths from heart failure.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Endocarditis presents a significant mortality risk.
- Effective management strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the impact of a formalized collaborative management policy for endocarditis.
- To assess changes in mortality rates and clinical outcomes following policy implementation.
Main Methods:
- Retrospective review of endocarditis cases over a decade.
- Analysis of data from a district general hospital with a multidisciplinary team approach.
- Comparison of outcomes before and after the inception of the collaborative policy.
Main Results:
- Overall endocarditis mortality decreased from 34% to 24%.
- Mortality among patients managed by the multidisciplinary team fell to 6%.
- No significant changes observed in prevalent organisms or infected valves; reduction in heart failure deaths noted.
Conclusions:
- Early referral and treatment by a multidisciplinary team significantly reduce mortality in bacterial endocarditis.
- Collaborative management is a highly effective strategy for improving endocarditis patient survival.
- The multidisciplinary approach addresses critical complications like heart failure effectively.
Abstract:
The present study represents a comprehensive retrospective review of endocarditis in a large district general hospital since the inception of a formalized policy involving collaborative management a decade ago. The principle was to involve a recognised team of cardiologists, specialists in infectious disease and microbiologists in the treatment of the disease from the moment of its diagnosis. The pattern of infection has not altered in terms of prevalent organisms and valves infected since the change in management policy. There has, however, been a significant decline in the mortality, from 34 to 24% for all patients with endocarditis. Amongst those referred for collaborative management, the mortality has fallen to 6%. The single greatest improvement is a reduction in the number of patients dying of heart failure, the number of patients developing systemic emboli or requiring prosthetic valve replacement remaining unchanged. The results indicate that early referral to, and treatment by, a multidisciplinary team can significantly reduce the mortality from bacterial endocarditis.