SPC365

Effectiveness of a Structured Multidisciplinary Team in Improving Outcomes in Infective Endocarditis

Session: Sessão de Posters 24 - Endocardite infeciosa: estratificação de risco, tratamento e desfechos
Speaker: Bárbara Antunes Rocha

Congress: CPC 2026
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 16. Infective Endocarditis
Subtheme: 16.8 Infective Endocarditis - Other
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Bárbara Antunes Rocha; João Faria; Carla Ferreira; Filipe Vilela; Mónica Dias; Sofia Fernandes; Inês Conde; Rita Marques; Luísa Graça; Juliana Martins; Alberto Salgado; Carlos Galvão Braga

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> Infective endocarditis (IE) carries substantial morbidity and mortality, and multidisciplinary care is recommended in contemporary guidelines. Endocarditis Teams aim to optimise diagnostic pathways, antimicrobial therapy, timing of surgery, and overall outcomes. A multidisciplinary Endocarditis Team composed of specialists in Cardiology, Internal Medicine, and Infectious Diseases was implemented in our centre. This study evaluated its impact on clinical management, complications, and mortality.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> We conducted a retrospective cohort study of consecutive adults diagnosed with IE between April 2021 and July 2025, with a minimum follow-up of three months. Patients were stratified into pre-team (n=52) and post-team (n=94) groups. Baseline characteristics, microbiology, imaging use, treatment pathways, and complications were compared. Mortality was assessed using chi-square analysis and multivariable logistic regression adjusting for age, sex, prosthetic valve, Staphylococcus aureus infection, and stroke. Risk ratios (RR) were also calculated.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> Baseline demographics and clinical features were similar between groups, with no significant differences in sex distribution, age, prosthetic valve prevalence, S. aureus infection (42.3% vs 23.4%, p=0.17), or surgical rates (40.4% vs 47.9%, p=0.393). Length of hospital stay, time to antibiotic initiation, duration of antibiotic therapy, time to advanced imaging, and time from surgical indication to operation showed no significant differences. Rates of cardiac, neurological, pulmonary, abdominal, limb, or other complications were also comparable (all p&gt;0.05). However, mortality was significantly lower after the introduction of the multidisciplinary Endocarditis Team (chi-square p=0.002). In adjusted analysis, team implementation remained independently associated with reduced mortality (OR 0.393, 95% CI 0.181&ndash;0.853; p=0.018), corresponding to a relative risk reduction of approximately 60% (RR 0.328). IE recurrence remained infrequent and similar across groups (1.9% vs 5.3%, Fisher p=0.422).</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion:</span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> The introduction of a structured multidisciplinary Endocarditis Team was independently associated with a significant reduction in mortality. Given that baseline characteristics, microbiological patterns, complications, and management timelines were similar between groups, the mortality benefit is unlikely to reflect differences in case severity. Instead, it likely stems from improved diagnostic supervision, more systematic antimicrobial optimisation, and greater consistency with guideline-directed care. These findings support the routine integration of multidisciplinary teams as an effective strategy to improve outcomes in infective endocarditis.</span></span></span></span></span></p>