The impact of establishing a regional infective endocarditis (IE) network on pre-operative IE-related complications and on post-operative outcome

Abstract Background Infective endocarditis (IE) requires a high degree of suspicion and advanced level multidisciplinary management. In 2015, the European guidelines recommended formation an endocarditis-team (ET) for optimal treatment IE. 2011, we already established ET within hospital that was only consulted on demand certain patients. Since has been increasingly involved in management almost all patients with addition, 2015 statewide endocarditis- (E) network referring hospitals. Purpose We investigated effect E-network reducing referral latency pre-operative IE-related complications. also adherence to recommendations our its impact post-operative stroke mortality. Methods retrospectively analyzed data from operated IE center between 01/2007 03/2018. conducted univariate analysis using Chi-square or Fisher's exact test, Multivariate logistic regression models in-hospital mortality stroke, Kaplan-Meier estimate 5-years survival. Results Among 630 center, 409 (65%) underwent surgery 1st era before 12/2014. S. aureus more frequent second (34% vs 25%, p<0.001). The median time onset symptoms 2nd halved compared first one [7 days (IQR 2–19) 15 6–35)]. Patients were admitted less complications, i.e. preoperative (14% 27%, p<0.001), heart failure (45% 69%, p<0.001) cardiac abscesses (24% 34%, p=0.018), acute renal insufficiency requiring hemodialysis (8% 14%, p=0.026). lack independent predictor (adjusted OR: 2.13, 95% CI: 1.27–3.53, p=0.004) 2.23, 1.12–4.39, p=0.02), associated worse survival (59% 40%, log rank<0.001). Conclusion Endocarditis-network led earlier patients, which resulted complications admission. Lack FUNDunding Acknowledgement Type funding sources: None. Figure 1 2