Conformité de la prise en charge globale des endocardites infectieuses dans un centre hospitalier périphérique

Abstract : This work evaluates the conformity of infective endocarditis (IE) management regarding to the european 2015 recommendations. Our objective was a conformity for at least 50% of patients. Methods A retrospective study was conducted in the hospital of Libourne between November 2015 and August 2018. All adult patients presented with modified Duke criteria for IE were included. Patients without blood-culture or echocardiography were excluded. Patient’s data were extracted from medical records systems. They were synthesized on a standardized document. The evaluation of conformity was performed by an experimented expert from our referent center. Results Seventy-six patients were included. Fifty-five patients (72%) presented with definite IE and twenty-one (28%) with possible IE. Fifty-nine patients (78%) had a management in concordance with european 2015 guidelines. Prosthetic valve endocarditis was associated with a non-compliant global management (p=0,030). The presence of a vegetation or an extra-cerebral embolism is associated with conformity of global management (respectively p=0,006 and p=0,015). Antibiotic therapy and surgery’s management were conforming respectively for 76% and 88% of patients. The in-hospital mortality concerned seventeen patients (22%). Thirteen patients (17%) had a surgical valve’s replacement. For fifty-three patients (70%), endocarditis management was discussed with a multidisciplinary team. Conclusion IE’s management in our facility is most of the time in concordance with european 2015 guidelines.
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Jonathan Lebreton. Conformité de la prise en charge globale des endocardites infectieuses dans un centre hospitalier périphérique. Médecine humaine et pathologie. Université de Bordeaux, 2019. Français. ⟨tel-02290740⟩

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