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- Title
Multidisciplinary Teams for the Management of Infective Endocarditis: A Systematic Review and Meta-analysis.
- Authors
Roy, Anne-Sophie; Hagh-Doust, Hamila; Azim, Ahmed Abdul; Caceres, Juan; Denholm, Justin T; Dong, Mei Qin (Denise); King, Madeline; Yen, Christina F; Lee, Todd C; McDonald, Emily G
- 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.
- Subjects
INFECTIVE endocarditis; RANDOM effects model; DATA extraction
- Publication
Open Forum Infectious Diseases, 2023, Vol 10, Issue 9, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofad444