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A. Basics
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01. History of Cardiology
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05. Atrial Fibrillation
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
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25. Interventional Cardiology
26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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The impact of admission at a hospital with cardiothoracic surgical unit onsite in the surgical management of patients hospitalized with infective endocarditis
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
Catarina Sousa
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.2 Infective Endocarditis – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Catarina Santos De Sousa; Paulo Nogueira; Fausto j. Pinto
Abstract
<p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Introduction</strong></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">Infective endocarditis (IE) is becoming ever more a surgical condition. However, only half of the patients with a clinical indication to surgery undergo surgical intervention.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Objective:</strong></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">We aimed to understand the impact of first admission in a hospital with onsite cardiac surgical unit (CSU) in the surgical management of patients hospitalized with IE.</span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Methods:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">A nationwide retrospective study of patients hospitalized with infective endocarditis, between 2010 and 2018, in Portugal.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Results:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">7574 patients were hospitalized with infective endocarditis from 2010 to 2018 in Portuguese public hospitals. 937 (12.4%) patients had cardiac valve surgery during the first hospitalization for IE. The proportion of patients firstly admitted in a hospital with a cardiothoracic surgery unit on-site undergoing surgery was substantially higher compared to only medical management patients (616 – 65,7% versus 2686- 40.5%, p >0.001). This variable was a significant predictor factor for cardiac valve surgery in the context of active IE (OR 4.36, CI 95% 3.65-5.2). Medical-surgical patients admitted in a hospital with surgical unit on-site presented a lower proportion of cardiac valve, prosthetic valve, infection with <em>Staphylococcus</em> and <em>Enterococcus</em> and complications such as acute heart or renal failure, ischemic stroke and systemic embolism compared to patients admitted in a hospital with no CSU and then transferred. No significant differences were noted regarding gender, age, or mortality rate.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Conclusion:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif">In Portugal, patients with active IE firstly admitted in a hospital with CSU onsite have a higher probability of undergoing surgical intervention. Additionally, clinical features of patients transferred from non-tertiary hospitals for cardiac surgery present higher complexity. It is crucial to further analyze factors influencing access to cardiac surgery in Portugal in the context of IE. </span></span></p>
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