Multidisciplinary Teams for the Management of Infective Endocarditis : A Systematic Review and Meta-analysis
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
Background: The management of infective endocarditis (IE) is complex owing to a high burden of morbidity and mortality. Recent guidelines recommend dedicated multidisciplinary teams (MDTs) for the management of IE. The aim of this systematic review and meta-analysis was to evaluate and summarize the effect of MDT management on patient outcomes.
Methods: A systematic review was performed and, where feasible, results were meta-analyzed; otherwise, results were summarized narratively. Data extraction and quality assessment were performed in duplicate. Restricted maximum likelihood random effects models were used to calculate unadjusted risk ratios and 95% CIs.
Results: Screening of 2343 studies based on title and abstract yielded 60 full-text reviews; 18 studies were summarized narratively, of which 15 were included in a meta-analysis of short-term mortality. Meta-analysis resulted in a risk ratio of 0.61 (95% CI, .47-.78; I2 = 62%) for mortality in favor of a dedicated MDT as compared with usual care. Length of stay was variable, with 55% (10/18) of studies reporting an increased length of stay. Most studies (16/18, 88.9%) reported a decreased time to surgery and an increased rate of surgery (13/18, 73%). No studies reported on patient-reported outcomes.
Conclusions: This is the first systematic review and meta-analysis to assess the impact of MDT management on IE. The sum of evidence demonstrated a significant association between MDTs and improved short-term mortality. Further research is needed to evaluate benefits of virtual MDT care, cost-effectiveness, and the impact on patient-reported outcomes and long-term mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Open forum infectious diseases - 10(2023), 9 vom: 21. Sept., Seite ofad444 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Roy, Anne-Sophie [VerfasserIn] |
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| Links: |
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| Themen: |
Endocarditis |
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| Anmerkungen: |
Date Revised 08.09.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ofid/ofad444 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361722761 |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a Background: The management of infective endocarditis (IE) is complex owing to a high burden of morbidity and mortality. Recent guidelines recommend dedicated multidisciplinary teams (MDTs) for the management of IE. The aim of this systematic review and meta-analysis was to evaluate and summarize the effect of MDT management on patient outcomes | ||
| 520 | |a Methods: A systematic review was performed and, where feasible, results were meta-analyzed; otherwise, results were summarized narratively. Data extraction and quality assessment were performed in duplicate. Restricted maximum likelihood random effects models were used to calculate unadjusted risk ratios and 95% CIs | ||
| 520 | |a Results: Screening of 2343 studies based on title and abstract yielded 60 full-text reviews; 18 studies were summarized narratively, of which 15 were included in a meta-analysis of short-term mortality. Meta-analysis resulted in a risk ratio of 0.61 (95% CI, .47-.78; I2 = 62%) for mortality in favor of a dedicated MDT as compared with usual care. Length of stay was variable, with 55% (10/18) of studies reporting an increased length of stay. Most studies (16/18, 88.9%) reported a decreased time to surgery and an increased rate of surgery (13/18, 73%). No studies reported on patient-reported outcomes | ||
| 520 | |a Conclusions: This is the first systematic review and meta-analysis to assess the impact of MDT management on IE. The sum of evidence demonstrated a significant association between MDTs and improved short-term mortality. Further research is needed to evaluate benefits of virtual MDT care, cost-effectiveness, and the impact on patient-reported outcomes and long-term mortality | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a infectious | |
| 650 | 4 | |a interdisciplinary | |
| 650 | 4 | |a multidisciplinary | |
| 650 | 4 | |a teams | |
| 700 | 1 | |a Hagh-Doust, Hamila |e verfasserin |4 aut | |
| 700 | 1 | |a Abdul Azim, Ahmed |e verfasserin |4 aut | |
| 700 | 1 | |a Caceres, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Denholm, Justin T |e verfasserin |4 aut | |
| 700 | 1 | |a Dong, Mei Qin Denise |e verfasserin |4 aut | |
| 700 | 1 | |a King, Madeline |e verfasserin |4 aut | |
| 700 | 1 | |a Yen, Christina F |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Todd C |e verfasserin |4 aut | |
| 700 | 1 | |a McDonald, Emily G |e verfasserin |4 aut | |
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