The impact of a policy of collaborative management on mortality and morbidity from infective endocarditis

Bain, R.J.I.; Glover, D. R.; Littler, W. A.; Geddes, A. M.

doi:10.1016/0167-5273(88)90189-1

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…those based around HIV, travel/immigrant or HITH services) and this is likely to influence the distribution of case mix seen by each unit. The value of targeted interdepartmental collaborations involving ID physicians has been shown, most specifically with regard to complex infections involving prosthetic joints [13], cardiac valves [14] and patients within either an internal medicine department [15] or intensive care [16]. The broad spectrum of referring departments is similar to that previously described in Europe and North America and highlights the inter-disciplinary nature of the speciality [2,6,7,10].…”

Section: Discussionmentioning

confidence: 74%

What do infectious diseases physicians do? A 2-week snapshot of inpatient consultative activities across Australia, New Zealand and Singapore

Ingram

Cheng

Murray

et al. 2014

Clinical Microbiology and Infection

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The practice of an infectious diseases (ID) physician is evolving. A contemporary understanding of the frequency and variety of patients and syndromes seen by ID services has implications for training, service development and setting research priorities. We performed a 2-week prospective survey of formal ID physician activities related to direct inpatient care, encompassing 53 hospitals throughout Australia, New Zealand and Singapore, and documented 1722 inpatient interactions. Infections involving the skin and soft tissue, respiratory tract and bone/joints together accounted for 49% of all consultations. Suspected/confirmed pathogens were primarily bacterial (60%), rather than viral (6%), fungal (4%), mycobacterial (2%) or parasitic (1%). Staphylococcus aureus was implicated in 409 (24%) episodes, approximately four times more frequently than the next most common pathogen. The frequency of healthcare-related infections (35%), immunosuppression (21%), diabetes mellitus (19%), prosthesis-related infections (13%), multiresistant pathogens (13%) and non-infectious diagnoses (9%) was high, although consultation characteristics varied between geographical settings and hospital types. Our study highlights the diversity of inpatient-related ID activities and should direct future teaching and research. ID physicians' ability to offer beneficial consultative advice requires broad understanding of, and ability to interact with, a wide range of referring specialities.

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Section: Discussionmentioning

confidence: 74%

What do infectious diseases physicians do? A 2-week snapshot of inpatient consultative activities across Australia, New Zealand and Singapore

Ingram

Cheng

Murray

et al. 2014

Clinical Microbiology and Infection

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“…We were not able to reproduce the lower mortality of some recent observation^.^ In some patients, the diagnosis of IE may not be apparent before death. 44 The awareness of potential fatal complications and their treatment are fundamental steps toward a better outcome for the patient^.^^,^^,^^ It is noteworthy that in our patients, heart failure, which was the leading cause of death of IE, 1.15.36 was replaced by uncontrolled infection and stroke. This modification is probably the result of the surgical treatment .…”

Section: Discussionmentioning

confidence: 99%

“…This modification is probably the result of the surgical treatment . 44 Neurologic complications were considered unaffected by contemporary therapy. 40 On the other hand, a recent study was unable to demonstrate increased mortality in patients with neurologic complications.…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis in the 1980s: Experience at a heart hospital

Mansur

Grinberg

Bellotti

et al. 1990

Clinical Cardiology

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Summary: Three hundred episodes of infective endocarditis (IE) in 287 patients were studied from October 1978 to August 1986. The patients were in the age range of 0.2-78 (mean 30.76k 16.06) years; 185 (68%) occurred in male patients. The etiologic agents were: Streptococci viriduns group (93), enterococci (2 l), streptococci D group, nonenterococci (19), other streptococci (14), Staphylococcus aureus (59), Staphylococcus epidermidis (14), gram-negative bacteria (16), other gram-positive bacteria (16), fungi (4). Etiologic agents were not isolated in 52 (negative cultures). Valvular heart diseases occurred in 23 1 episodes, congenital heart diseases in 37, other heart diseases in 6. Sixty-nine occurred in patients with prosthetic heart valves. In 69 there was no previous heart disease. Surgical treatment was performed in 102 episodes (37 with prosthetic valve IE and 65 with native valve IE); 22 patients (21 %) died, 12 with prosthetic valve and 10 with native valve IE. The in-hospital mortality (medical and surgical patients) was 26 % (78 patients). Long-term follow-up of 206 patients up to 7.1 (mean 2.13 k 1.68) years revealed that 26 patients died. Thus, IE remains a disease with high mortality and is fatal to a third of the patients, in spite of the progress in therapeutic methods. Its morbidity and mortality continues beyond the microbiological cure.

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“…15-26-27 In fact, uncontrolled infection may be responsible for the patient deaths in the early days of hospitalization. 5 Complications associated with antimicrobial therapy were not uncommon; we observed 35 complications (11.6%) in our 300 episodes of endocarditis, in the lower range of the 12% to 18% previously reported.611,28 Strepto¬ mycin toxic effects were observed in nine cases. They were reported in three of eight patients, mainly elderly people.29…”

Section: Commentmentioning

confidence: 63%

“…This observation, however, is to some extent biased by the (10) 2(2) 2(2) 4(4) 1(1)1(1) 2(2) Enterococci 22 21 4/2(28) 3 (14) 0(0) 0(0) 0(0) 1(5) 7(33) 1(5) 1(5) 1(5) 0(0)1(5) 1 (5) Croup D 12 19 3/3(31) 2(10) 1(5) 0(0) 0(0) 0(0) 2(10) 0(0) 0(0) 0(0) 0(0)0(0) 1 (5) nonenterococci Others 13 14 4/2(43) 3(21) 0(0) 0(0) 3(21) 0(0) 1(7) 0(0) 0(0) 0(0) 0(0)0(0) 0(0) Staphylococci Staphylococcus 119 59 7/14 (35)16(27) 4(7) 15 (25)23(39) 12(20)11(19) 4(7) 0(0) 5(8) 1(2)1(2) (52)15(29) 6(11) 5(10) 7(13) 12(23) 9(17) 1(2) 2(4) 4(8) 0(0)0(0) 8(15) (negative culture) Total 386 300 61/39 (33)72(24)16(5) 26(9) 46(15) 27(9) 41(16)11(4) 6(2) 16(5) 3(1)3(1)19(6) "Percentages are percentages of episodes with the complication. H/S indicates hemodynamic/structural cardiac complications; Neu, neurologic complications; SAE, extracranial systemic arterial embolism; SPE, septic pulmonary embolism; Trt, complications from medical treatment; Sur, com¬ plications associated with surgical treatment; Prt, acute prosthetic valve insufficiency; EMA, extracranial mycotic aneurysm; SAI, splenic abscess or infarction; and Arr, cardiac arrhythmia.…”

Section: Commentmentioning

confidence: 99%