多学科内心炎团队对感染性内心炎管理的影响
Nicolas Fourré1, Virgile Zimmermann1, Benoit Guery1
1Lausanne University Hospital and University of Lausanne, Infectious Diseases Service, Lausanne, Switzerland.
概括
建立内心炎团队改善了感染性内心炎 (IE) 管理,增加了心脏手术率,减少了栓塞事件. 这种多学科的方法提高了患者的护理,但没有影响死亡率.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗保健管理的管理
背景情况:
- 传染性内心炎 (IE) 是一种严重的,危及生命的疾病,需要复杂的管理.
- 建立专门的多学科团队旨在优化患者护理途径.
- 评估内心炎团队 (ET) 对IE管理的影响对于改善结果至关重要.
研究的目的:
- 评估内心炎团队对传染性内心炎的临床管理的影响.
- 为了比较患者的结果和治疗策略在实施ET之前和之后.
主要方法:
- 2015-2022年在一所大学医院进行的观察性研究,比较了ET前 (2015-2017) 和ET后 (2018-2022) 时期.
- 分析了505个感染性内心炎发作,评估了诊断工具的使用 (例如,18F-FDG PET/CT) 和治疗模式.
- 两个研究期间间的手术指示,手术,死亡率和栓塞事件的比较.
主要成果:
- 18F-FDG PET/CT的使用在ET后的时期翻了一番 (14%vs28%).
- 较短的静脉注射抗菌药物治疗持续时间 (4周与6周相比) 在ET后更常见 (15%与45%相比).
- 心脏外科手术的接受率显著增加 (66%vs78%),导致手术指示患者的随后栓塞事件减少 (23%vs12%).
结论:
- 心内膜炎团队改善了感染性心内膜炎的管理,特别是在优化手术干预方面.
- 在ET实施后心脏手术率的增加与栓塞事件的减少有关.
- 虽然死亡率保持不变,但ET促进了更好的整体患者管理,并降低了并发症率.
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