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Multidisciplinary Teams for the Management of Infective Endocarditis: A Systematic Review and Meta-analysis
Anne-Sophie Roy1, Hamila Hagh-Doust1, Ahmed Abdul Azim2
1Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
Open Forum Infectious Diseases
|September 7, 2023
Summary
Multidisciplinary teams (MDTs) significantly reduce short-term mortality in infective endocarditis (IE) management. This systematic review highlights MDT benefits, though further research on patient-reported outcomes is needed.
Area of Science:
- Cardiology
- Infectious Diseases
- Health Services Research
Background:
- Infective endocarditis (IE) presents significant morbidity and mortality challenges.
- Current guidelines advocate for dedicated multidisciplinary teams (MDTs) in IE patient management.
- The effectiveness of MDT management on patient outcomes requires comprehensive evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the impact of MDT management on patient outcomes in infective endocarditis.
- To synthesize evidence regarding the efficacy of dedicated MDTs compared to usual care.
Main Methods:
- A systematic review and meta-analysis of relevant studies.
- Data extraction and quality assessment performed by two independent reviewers.
- Restricted maximum likelihood random effects models utilized for meta-analysis of short-term mortality.
Main Results:
- Meta-analysis of 15 studies showed a reduced risk ratio of 0.61 (95% CI, .47-.78) for mortality with MDT management.
- Most studies reported decreased time to surgery and increased rates of surgical intervention.
- Length of stay varied, with a majority of studies reporting an increase.
Conclusions:
- MDT management is significantly associated with improved short-term mortality in IE.
- Further research is warranted to explore virtual MDT care, cost-effectiveness, and long-term patient-reported outcomes.
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