Impact of an Infective Endocarditis Team on Management and Outcomes: A Retrospective Cohort Study

Area of Science:

• Cardiology
• Infectious Diseases
• Healthcare Management

Background:

• Infective endocarditis (IE) is a serious infection requiring complex management.
• Multidisciplinary team (MDT) approaches are suggested to enhance IE care.
• The impact of an established IE team on clinical outcomes in Japan was evaluated.

Purpose of the Study:

• To assess the effect of an IE team on patient management and outcomes.
• To compare outcomes before and after the implementation of an IE team at a tertiary care facility.
• To identify specific improvements in IE patient care attributable to the team approach.

Main Methods:

• Retrospective study of adult inpatients with definite IE (November 2015 - October 2023).
• Comparison of outcomes between a control period (before IE team) and an intervention period (after IE team establishment in November 2019).
• Primary outcome: 90-day all-cause mortality. Secondary outcomes: in-hospital mortality, unplanned cardiac surgery, cerebral embolism, bacteremia relapse, and antibiotic duration.

Main Results:

• No significant differences in 90-day mortality (15.2% vs 17.0%) or in-hospital mortality (19.6% vs 12.8%).
• Unplanned cardiac surgery rates significantly decreased in the intervention period (17.4% vs 2.1%, P=0.02).
• Longer antibiotic therapy duration observed in the intervention period (6.0 vs 7.5 weeks, P=0.02); no bacteremia relapse occurred.

Conclusions:

• The IE team approach was associated with a significant reduction in unplanned cardiac surgeries.
• While overall 90-day mortality did not change, the decrease in unplanned surgeries suggests clinical benefit.
• Extended antibiotic therapy may indicate management of more complex IE cases, including abscesses.