Changes in Clinical Profile, Epidemiology and Prognosis of Left-sided Native-valve Infective Endocarditis Without Predisposing Heart Conditions (original) (raw)

Abstract

in 92, and so 46 patients may have experienced a delay in reperfusion, that is, 7.2% of the overall series. The data presented are only applicable to the network described, as the demographic characteristics, geography, hospital network, and catheterization laboratories vary for each region. 4 The fact that overlap started when the catheterization team was activated instead of when the patient arrived in the room may have increased the percentage of patients reported to have a delay. However, the end time of the procedure is not always predictable and, if the activity had been concentrated in a single center, the transfer times would have been longer for 40% of the patients in the catchment area of the second center. This may have led to overlap with patients other than those indicated, greater ambulance use with a subsequent deterioration in other areas of care, and increased mortality due to delays. 5 There may also have been an increase in the percentage of patients referred for fibrinolysis if the option of a second center were not available, while some of the 6 patients who experienced delay and who did not undergo PPCI may have received unnecessary fibrinolysis. In summary, we believe that the design of regional networks should take potential demand into account and, once in operation, the percentage of patients who have experienced delays in the past year could be used as an indicator analyzed in annual steering committee meetings for the regional network.

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References (12)

  1. Srinivas VS, Hailpern SM, Koss E, Monrad ES, Alderman MH. Effect of physician volume on the relationship between hospital volume and mortality during primary angioplasty. J Am Coll Cardiol. 2009;53:574-9.
  2. Bassand JP, Danchin N, Filippatos G, Gitt A, Hamm C, Silber S, et al. Implementa- tion of reperfusion therapy in acute myocardial infarction. A policy statement from the European Society of Cardiology. Eur Heart J. 2005;26:2733-41.
  3. Kristensen SD, Laut KG, Fajadet J, Kaifoszova Z, Kala P, Di Mario C, et al. Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries. Eur Heart J. 2014;35:1957-70.
  4. I ´n ˜iguez A, Jime ´nez VA, Baz JA, Barreiros MV. Resultados tras 6 an ˜os de funcio- namiento -A ´rea Sur (PROGALIAM Sur). Rev Esp Cardiol. 2013;66:506-7.
  5. Rodrı ´guez-Leor O, Ferna ´ndez-Nofrerias E, Mauri F, Salvatella N, Carrillo X, Curo ´s A, et al. Ana . Rev Esp Cardiol. 2011;64:476-83. http://dx.doi.org/10.1016/j.rec.2014.12.015 REFERENCES
  6. Ferna ´ndez-Hidalgo N, Tornos P. Epidemiologı ´a de la endocarditis infecciosa en Espan ˜a en los u ´ltimos 20 an ˜os. Rev Esp Cardiol. 2013;66:728-33.
  7. Castillo JC, Anguita M, Ruiz M, Pen ˜a L, Santisteban M, Puentes M, et al. Cambios epidemiolo ´gicos de la endocarditis infecciosa sobre va ´lvula nativa. Rev Esp Cardiol. 2011;64:594-8.
  8. Ferna ´ndez-Hidalgo N, Almirante B, Tornos P, Gonza ´lez-Alujas M, Planes A, Galin ˜anes M, et al. Immediate and long-term outcome of left-sided infective endocarditis. A 12-year prospective study from a contemporary cohort in a referral hospital. Clin Microbiol Infect. 2012;18:E522-30.
  9. Lo ´pez J, Revilla A, Vilacosta I, Sevilla T, Villacorta E, Sarria ´C, et al. Age-dependent profile of left-sided infective endocarditis: a 3-center experience. Circulation. 2010;121:892-7.
  10. Olmos C, Vilacosta I, Ferna ´ndez C, Carria ´C, Lo ´pez J, del Trigo M, et al. Comparison of clinical features of left-sided infective endocarditis involving previously normal versus previously abnormal valves. Am J Cardiol. 2014;114:278-83.
  11. Carrasco-Chinchilla F, Sa ´nchez-Espı ´n G, Ruiz-Morales J, Rodrı ´guez-Bailo ´n I, Melero-Tejedor JM, Ivanova-Georgieva R, et al. Influencia de una estrategia de alerta multidisciplinaria en la mortalidad por endocarditis infecciosa izquierda. Rev Esp Cardiol. 2014;67:380-6.
  12. http://dx.doi.org/10.1016/j.rec.2014.12.014