Back to Search
Start Over
Multidisciplinary Teams for the Management of Infective Endocarditis: A Systematic Review and Meta-analysis.
- Source :
-
Open Forum Infectious Diseases . Sep2023, Vol. 10 Issue 9, p1-11. 11p. - Publication Year :
- 2023
-
Abstract
- 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; I 2 = 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *INFECTIVE endocarditis
*RANDOM effects model
*DATA extraction
Subjects
Details
- Language :
- English
- ISSN :
- 23288957
- Volume :
- 10
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Open Forum Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 172896080
- Full Text :
- https://doi.org/10.1093/ofid/ofad444