دورية أكاديمية
A clinical audit on the diagnosis and management of infective endocarditis in a tertiary heart centre in Malaysia.
| العنوان: | A clinical audit on the diagnosis and management of infective endocarditis in a tertiary heart centre in Malaysia. |
|---|---|
| المؤلفون: | Ho YH; Sarawak Heart Center, Cardiology, Kota Samarahan, Sarawak, Malaysia., Lim CT; Sarawak Heart Center, Cardiology, Kota Samarahan, Sarawak, Malaysia. carynlim1992@gmail.com., Chua CZF; Sarawak Heart Center, Cardiology, Kota Samarahan, Sarawak, Malaysia., Chua HH; Sarawak General Hospital, Department of Medicine, Infectious Disease Unit, Ministry of Health, Malaysia., Ong TK; Sarawak Heart Center, Cardiology, Kota Samarahan, Sarawak, Malaysia. |
| المصدر: | The Medical journal of Malaysia [Med J Malaysia] 2024 Jul; Vol. 79 (4), pp. 388-392. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Malaysian Medical Association Country of Publication: Malaysia NLM ID: 0361547 Publication Model: Print Cited Medium: Internet ISSN: 0300-5283 (Print) Linking ISSN: 03005283 NLM ISO Abbreviation: Med J Malaysia Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Kuala Lumpur : Malaysian Medical Association |
| مواضيع طبية MeSH: | Tertiary Care Centers* , Clinical Audit* , Endocarditis*/diagnosis , Endocarditis*/therapy, Humans ; Malaysia ; Male ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Anti-Bacterial Agents/therapeutic use ; Echocardiography ; Aged |
| مستخلص: | Introduction: Infective endocarditis (IE) has a high mortality rate in developing countries including Malaysia. This clinical audit aims to identify the shortcomings in the diagnosis and management of IE patients in a local tertiary centre to implement changes for improvement. Materials and Methods: This retrospective audit had two cycles - the first includes all IE patients in Sarawak Heart Centre, Malaysia from January 2020 to December 2022 with different parameters (blood culture, echocardiogram, the appropriateness of antibiotics and surgery) assessed against Malaysian Clinical Practice Guideline (CPG); and reaudit from July 2023 to December 2023. Interventions before re-audit include presentation at different hospital levels and continuing medical education. Results: Fifty patients were recruited (37 in the first cycle, 13 in the second cycle). The median age was 48.5 years with male predominance. Valve prosthesis (12.0%) and rheumatic heart disease (10.0%) were the commonest predisposing factors. Native mitral (44.0%) and aortic valves (28.0%) were most commonly involved. Twenty-eight (56.0%) patients were culture-positive. In the first cycle, most parameters (culture technique 0.0%, vegetation measured 54.1%, empirical 5.4%, culture-guided 29.7% antibiotics therapy, indicated surgery 0.0%) did not achieve the expected standard except timeliness of echocardiograms and blood culture incubation period. After initial interventions, all parameters showed statistically significant improvement (culture technique p<0.001, echocardiography p<0.001, empirical p<0.001, culture-guided p=0.021, surgery p<0.001) during the re-audit. Conclusion: Compliance with clinical practice guidelines (CPG) on IE management was suboptimal during the first audit but improved after interventions. Hence, regular continuing medical education (CME) is essential, and a written hospital protocol may be useful. Regular audits alongside multidisciplinary teamwork are crucial efforts. |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20240801 Date Completed: 20240801 Latest Revision: 20240801 |
| رمز التحديث: | 20240801 |
| PMID: | 39086334 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0300-5283 |
|---|