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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | patient for whom diagnosis and medical care are realized in a referent center with cardiac surgery |
| |
| Group II | patients secondary addressed to a referent center with cardiac surgery |
| |
| Group III | patients for which the totality medical care are performed in non-referent health center |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| determine the prognosis of threated patients according to the clinical care pathway. | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| the all-cause one-year mortality according to the group | one year |
| Measure | Description | Time Frame |
|---|---|---|
| the application of European recommendations | realization of trans-oesophageal echocardiogram (TOE) | one year |
| antibiotic treatment | type and time of antibiotic treatment for common germ, |
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Inclusion Criteria:
- adult with infective endocarditis episode according to Duke Criteria
Exclusion Criteria:
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all adults with infective endocarditis episode
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gilbert HABIB | Contact | 04 91 38 75 87 | gilbert.habib@ap-hm.fr |
| Name | Affiliation | Role |
|---|---|---|
| Urielle DESALBRES | Assistance Publique Hôpitaux de Marseille | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assistance Publique Hôpoitaux de Marseille Hôpital de la Timone | Recruiting | Marseille | 13354 | France |
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| ID | Term |
|---|---|
| D004696 | Endocarditis |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| one year |
| surgery | performing valve surgery and / or total extraction of an implanted pacemaker or defibrillator. | one year |