Impact of Clinical Care Pathway on Prognosis and Therapeutic Medical Care of Infective Endocarditis

Public Assistance-Hospitals of Marseille (AP-HM)

Status: Unknown

Conditions: Infective Endocarditis (IE)

Treatments: Other: determine the prognosis of threated patients according to the clinical care pathway.

Study type: Observational

Funder types: Other

Identifiers

NCT02856607

RC12_3675

Details and patient eligibility

About

Infective endocarditis (IE) is defined as a bacterial infection of the endocardium (inner surface of the heart), which may include one or more heart valves. Epidemiologic pattern has changed during the last 20 years whereas the incidence was unchanged. However, the mortality increase despite recent diagnosis and therapeutic advances.

Only few investigations consider the prognostic and the therapeutic medical care according to the clinical care pathway. In fact, 3 situations are observed: (i) patient for whom diagnosis and medical care are realized in a referent center with cardiac surgery, (ii) patients secondary addressed to a referent center with cardiac surgery, (iii) patients for which the totality medical care are performed in non-referent health center. In addition, epidemiologic studies concern only a part of IE, not including most of the time the patients hospitalized in non-referent center.

The aim of the study was to determine the prognosis of threated patients according to the clinical care pathway. Secondary objectives was (i) to evaluate the application of European recommendations concerning trans-oesophageal echocardiogram (TOE), antibiotic treatment and surgical practice, (ii) to compare the epidemiologic profile according to the type of center.

For this, 300 patients addressed in the 22 French participating centers for a possible or certain IE according to Duke Criteria were prospectively included during 3 years.

Patient data (clinical, demographical, biological, microbiological, echocardiographic and evolutive data) were collected at the admission, during hospitalization, at discharge and one-year follow up.

Enrollment: 300 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult with infective endocarditis episode according to Duke Criteria

Exclusion criteria

• Patients with a new episode of infective endocarditis that led to its prior inclusion in the study

Trial design

300 participants in 3 patient groups

Group I

Description:

patient for whom diagnosis and medical care are realized in a referent center with cardiac surgery

Treatment:

Other: determine the prognosis of threated patients according to the clinical care pathway.

Group II

Description:

patients secondary addressed to a referent center with cardiac surgery

Treatment:

Other: determine the prognosis of threated patients according to the clinical care pathway.

Group III

Description:

patients for which the totality medical care are performed in non-referent health center

Treatment:

Other: determine the prognosis of threated patients according to the clinical care pathway.