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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 157] [Impact Index Per Article: 157.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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Malinauskas R, Malinauskas M, Malinauskiene V, Zabiela V. Perceived Stress in Relation to Demographics and Clinical Forms among Patients with Infective Endocarditis: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14073. [PMID: 36360948 PMCID: PMC9656878 DOI: 10.3390/ijerph192114073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Infective endocarditis (IE) is a disease of the endocardial surface of the heart, caused by infection of the native or prosthetic valve or an indwelling cardiac device. Apart from IE predisposing risk factors that include heart conditions and medical procedures, the novel trajectories from demographic factors to perceived stress conditions have been under investigation in recent years. The aim of the present study was to evaluate the associations between perceived stress and demographic characteristics as well as clinical forms of IE among survivors of IE in Kaunas, Lithuania. (2) Methods: A cross-sectional study among IE cases (n = 135) at the Lithuanian University of Health Sciences Kaunas Clinics Cardiology department during the period 2014-2017 was performed. Data about IE clinical features, sociodemographic characteristics and perceived stress level (Perceived Stress Scale (PSS-10)) upon diagnosis were collected. Package "SPSS 25.0" was used in the statistical analysis. Logistic regression analysis was performed including gender, previous occupation, place of residence and clinical forms of IE in the analysis of perceived stress among survivors of IE. The STROBE checklist for cross-sectional studies was used in this study. (3) Results: Perceived stress was experienced by 54.8 percent of the respondents. In the final model, the OR (odds ratio) of perceived stress for females was 2.07 as compared to men; for rural residents, the OR was 2.25 as compared to urban residents. These results were statistically significant. A tendency for increased OR of perceived stress for low-skilled workers as compared to high-skilled ones and classical IE clinical form as compared to non-classical form was observed, but these results were not statistically significant. (4) Conclusions: The present study is an attempt to focus the attention of IE researchers on the effects of psychological state in the disease development. Differences in perceived stress and some demographic characteristics, as well as tendencies of IE clinical forms, were observed among survivors of IE in Kaunas, Lithuania.
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Affiliation(s)
- Romualdas Malinauskas
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Mindaugas Malinauskas
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Street 2, LT-50161 Kaunas, Lithuania
| | - Vilija Malinauskiene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania
| | - Vytautas Zabiela
- Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Street 2, LT-50161 Kaunas, Lithuania
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3
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Saha S, Mladenova R, Radner C, Horke KM, Buech J, Schnackenburg P, Ali A, Peterss S, Juchem G, Luehr M, Hagl C, Joskowiak D. Health-Related Quality of Life following Surgery for Native and Prosthetic Valve Infective Endocarditis. J Clin Med 2022; 11:jcm11133599. [PMID: 35806881 PMCID: PMC9267565 DOI: 10.3390/jcm11133599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/12/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives: The objective of this study was to compare the long-term outcomes and health-related quality of life (HRQOL) of patients following surgery for infective native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). Methods: We retrospectively identified 633 consecutive patients who had undergone surgery for infective endocarditis at our center between January 2005 and October 2018. The patients were interviewed, and the SF-36 survey was used to assess the HRQOL of survivors. Propensity score matching (2:1) was performed with data from a German reference population. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model. Results: The median age of the cohort was 67 (55–74) years, and 75.6% were male. Operative mortality was 13.7% in the NVE group and 21.6% in the PVE group (p = 0.010). The overall survival at 1 year was 88.0% and was comparable between the groups. The physical health summary scores were 49 (40–55) for the NVE patients and 45 (37–52) for the PVE patients (p = 0.043). The median mental health summary scores were 52 (35–57) and 49 (41–56), respectively (p = 0.961). On comparison of the HRQOL to the reference population, the physical health summary scores were comparable. However, significant differences were observed with regard to the mental health summary scores (p = 0.005). Conclusions: Our study shows that there are significant differences in the various domains of HRQOL, not only between NVE and PVE patients, but also in comparison to healthy individuals. In addition to preoperative health status, it is important to consider the patient’s expectations regarding surgery. Further prospective studies are required.
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Affiliation(s)
- Shekhar Saha
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
- Correspondence: author:
| | - Ralitsa Mladenova
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
| | - Caroline Radner
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Konstanze Maria Horke
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Joscha Buech
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Philipp Schnackenburg
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Ahmad Ali
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Sven Peterss
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Gerd Juchem
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Maximilian Luehr
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Dominik Joskowiak
- Department of Cardiac Surgery, Ludwig Maximillian University of Munich, 81377 Munich, Germany; (R.M.); (C.R.); (K.M.H.); (J.B.); (P.S.); (A.A.); (S.P.); (G.J.); (M.L.); (C.H.); (D.J.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
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4
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Bundgaard JS, Iversen K, Pries-Heje M, Ihlemann N, Gill SU, Madsen T, Elming H, Povlsen JA, Bruun NE, Høfsten DE, Fuursted K, Christensen JJ, Schultz M, Rosenvinge F, Helweg-Larsen J, Køber L, Torp-Pedersen C, Fosbøl EL, Tønder N, Moser C, Bundgaard H, Mogensen UM. Self-assessed health status and associated mortality in endocarditis: secondary findings from the POET trial. Qual Life Res 2022; 31:2655-2662. [PMID: 35349038 DOI: 10.1007/s11136-022-03126-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Self-assessed poor health status is associated with increased risk of mortality in several cardiovascular conditions, but has not been investigated in patients with endocarditis. We examined health status and mortality in patients with endocarditis. METHODS This is a re-specified substudy of the randomized POET endocarditis trial, which included 400 patients. Patients completed the single-question self-assessed health status from the Short-Form 36 questionnaire at time of randomization and were categorized as having poor or non-poor (excellent/very good, good, or fair) health status. Self-assessed health status and all-cause mortality were examined by a Cox regression model. RESULTS Self-assessed health status was completed by 266 (67%) patients with a mean age of 68.0 years (± 11.8), 54 (20%) were females, and 86 (32%) had one or more major concurrent medical conditions besides endocarditis. The self-assessed health status distribution was poor (n = 21, 8%) and non-poor (n = 245, 92%). The median follow-up was 3.3 years and death occurred in 9 (43%) and 48 (20%) patients reporting poor and non-poor health status, respectively, and mortality rates [mortality/100 person-years, 95% confidence interval (CI)] were 18.1 (95% CI 9.4-34.8) and 5.4 (95% CI 4.1-7.2), i.e., the crude hazard ratio for death was 3.4 (95% CI: 1.7-7.0, p < 0.01). CONCLUSION Self-assessed poor health status compared with non-poor health status as assessed by a single question was associated with a threefold increased long-term mortality in patients with endocarditis. POET ClinicalTrials.gov number, NCT01375257. TRIAL REGISTRY POET ClinicalTrials.gov number, NCT01375257.
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Affiliation(s)
- Johan S Bundgaard
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Kasper Iversen
- Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mia Pries-Heje
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Nikolaj Ihlemann
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Sabine U Gill
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Trine Madsen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Hanne Elming
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Jonas A Povlsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Niels E Bruun
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.,Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.,Clinical Institute, Aalborg University, Aalborg, Denmark
| | - Dan E Høfsten
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark
| | - Jens J Christensen
- The Regional Department of Clinical Microbiology, Region Zealand Slagelse Hospital, Region Zealand, Denmark
| | - Martin Schultz
- Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Flemming Rosenvinge
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Jannik Helweg-Larsen
- Department of Infectious Diseases, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark
| | - Emil L Fosbøl
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Niels Tønder
- Department of Cardiology, North Zealand University Hospital, Hillerød, Denmark
| | - Claus Moser
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik M Mogensen
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
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5
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Bundgaard JS, Iversen K, Pries-Heje M, Ihlemann N, Bak TS, Østergaard L, Gill SU, Madsen T, Elming H, Jensen KT, Bruun NE, Høfsten DE, Fuursted K, Christensen JJ, Schultz M, Rosenvinge F, Schønheyder HC, Helweg-Larsen J, Køber L, Torp-Pedersen C, Fosbøl EL, Tønder N, Moser C, Bundgaard H, Mogensen UM. The impact of partial-oral endocarditis treatment on anxiety and depression in the POET trial. J Psychosom Res 2022; 154:110718. [PMID: 35078079 DOI: 10.1016/j.jpsychores.2022.110718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The Partial-Oral versus Intravenous Antibiotic Treatment of Endocarditis Trial (POET) found that partial-oral outpatient treatment was non-inferior to conventional in-hospital intravenous treatment in patients with left-sided infective endocarditis. We examined the impact of treatment strategy on levels of anxiety and depression. METHODS Patients completed the Hospital Anxiety and Depression Scale (HADS) at randomization, at antibiotic completion, and after month 3 and month 6. Changes in anxiety and depression (each subdimension 0-21, high scores indicating worse) were calculated using a repeated measure analysis of covariance model with primary assessment after 6 months. Change in score of 1.7 represented a minimal clinical important difference (MCID). RESULTS Among the 400 patients enrolled in the POET trial, 263 (66%) completed HADS at randomization with reassessment rates of 86-87% at the three subsequent timepoints. Patients in the partial-oral group and the intravenous group had similar improvements after 6 months in levels of anxiety (-1.8 versus -1.6, P = 0.62) and depression (-2.1 versus -1.9, P = 0.63), although patients in the partial-oral group had numerically lower levels of anxiety and depression throughout. An improvement in MCID scores after 6 months was reported by 47% versus 45% (p = 0.80) patients for anxiety and by 51% versus 54% (p = 0.70) for depression. CONCLUSION Patients with endocarditis receiving partial-oral outpatient treatment reported similar significant improvements in anxiety and depression at 6 months, as compared to conventionally treated, but numerically lower levels throughout. These findings support the usefulness of partial-oral treatment.
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Affiliation(s)
- Johan S Bundgaard
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Kasper Iversen
- Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mia Pries-Heje
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nikolaj Ihlemann
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Theis S Bak
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lauge Østergaard
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Cardiology, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sabine U Gill
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Trine Madsen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Hanne Elming
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Kaare T Jensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Niels E Bruun
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark; Institute of Clinical Medicine, Copenhagen University and Clinical Institute Aalborg University, Denmark
| | - Dan E Høfsten
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kurt Fuursted
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Jens J Christensen
- The Regional Department of Clinical Microbiology, Region Zealand Slagelse Hospital, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Schultz
- Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Rosenvinge
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - Henrik C Schønheyder
- Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark
| | - Jannik Helweg-Larsen
- Department of Infectious diseases, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Department of cardiology, Nordsjaellands Hospital, Hillerød, Denmark
| | - Emil L Fosbøl
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Tønder
- Department of Cardiology, North Zealand University Hospital, Hillerød, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Claus Moser
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik M Mogensen
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Rasmussen TB, Zwisler AD, Risom SS, Sibilitz KL, Christensen J, Bundgaard H, Moons P, Thygesen LC, Lindschou J, Norekvål TM, Berg SK. Comprehensive cardiac rehabilitation for patients following infective endocarditis: results of the randomized CopenHeartIE trial. Eur J Cardiovasc Nurs 2021; 21:261-270. [PMID: 34089600 DOI: 10.1093/eurjcn/zvab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/17/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022]
Abstract
AIMS Infective endocarditis is a complex and highly mortal disease requiring lengthy treatment. Physical and mental deconditioning is common. Nonetheless, rehabilitation is virtually unexplored in this population. The aim of this trial was therefore to investigate the effects of cardiac rehabilitation in patients following endocarditis. METHODS AND RESULTS In a randomized trial, adults with left-sided or cardiac device endocarditis were randomized 1:1 to 12 weeks of physical exercise training and five psycho-educational consultations (cardiac rehabilitation) vs. usual care without rehabilitation (control). Primary outcome was mental health measured by SF-36 Mental Component Summary (MCS) at 6 months. Secondary outcome was physical capacity measured by peak oxygen uptake (VO2) at 4 months. Exploratory outcomes were investigated. Low inclusion rate resulted in trial termination before reaching the target sample size. A total of 117 participants (mean age: 60 years, 81% male) were randomized to cardiac rehabilitation (n = 58) or to control (n = 59). Mental health and physical capacity at baseline were generally poor (MCS: 38.9-42.2 points, VO2 peak: 16.1-16.6 mL/kg/min). Cardiac rehabilitation compared with control showed no effect on mental health (MCS: 44.6 points vs. 48.8 points, P = 0.41) or physical capacity (VO2 peak: 19.9 mL/kg/min vs. 18.0 mL/kg/min, P = 0.09). Effects favouring the intervention were identified in exploratory outcomes including general fatigue (P = 0.005), and physical capacity as maximal power (W) (P = 0.005). Adherence to the intervention was 28%. CONCLUSIONS Results indicate no effect of cardiac rehabilitation in patients following endocarditis; however, lack of statistical power and poor adherence render findings inconclusive. Valuable insight into patients' capabilities and safety was gained, and further investigations into rehabilitation needs and modes of delivery in this high-need population should be a future priority.
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Affiliation(s)
- Trine Bernholdt Rasmussen
- The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark.,Department of Cardiology, Herlev and Gentofte University Hospital, Kildegaardsvej 28, Hellerup 2900, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen O 1014, Denmark
| | - Ann-Dorthe Zwisler
- Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, Nyborg 5800, Denmark
| | - Signe Stelling Risom
- The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen O 1014, Denmark.,Institute for Nursing and Nutrition, University College Copenhagen, Tagensvej 86, Copenhagen N 2200, Denmark
| | - Kirstine Lærum Sibilitz
- The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark
| | - Jan Christensen
- Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, Nyborg 5800, Denmark.,Department of Occupational and Physiotherapy, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark
| | - Henning Bundgaard
- The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark
| | - Philip Moons
- Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 35 blok d, Leuven, box 7001, B-3000, Belgium.,Institute of Health and Care Science, University of Gothenburg, Arvid Wallgrens backe 1, Göteborg 413 46, Sweden.,Department of Paediatrics and Child Health, University of Cape Town, 46 Sawkins Rd, Rosebank, Cape Town 7700, South Africa
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, Copenhagen K 1455, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital Rigshospitalet, Tagensvej 22, Copenhagen N 2200, Denmark
| | - Tone Merete Norekvål
- Department of Heart Disease, Haukeland University Hospital, Haukelandsveien 22, Bergen 5021, Norway.,Department of Clinical Science, University of Bergen, Jonas Lies veg 87, Bergen, 5021, Norway
| | - Selina Kikkenborg Berg
- The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen O 2100, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen O 1014, Denmark
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7
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Palm P, Missel M, Zwisler AD, Svendsen JH, Giraldi A, Berg SK. A place of understanding: Patients' lived experiences of participating in a sexual rehabilitation programme after heart disease. Scand J Caring Sci 2019; 34:370-379. [PMID: 31313855 DOI: 10.1111/scs.12738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 01/06/2023]
Abstract
AIMS AND OBJECTIVES The aim of this project was to explore the lived experience of participating in a nonpharmacological sexual rehabilitation programme. BACKGROUND In the healthcare system, patients are important stakeholders, and their experience and knowledge are essential to include when evaluating rehabilitation programmes. Patient experiences with participating in sexual rehabilitation for cardiovascular patients have not yet been investigated. METHODS Ten qualitative interviews were conducted with male patients from a randomised controlled trial investigating the effect of a 12-week rehabilitation programme focusing on sexuality. The analysis was inspired by Paul Ricoeur's theory of interpretation. Analysis consisted of three levels: (i) naive reading, (ii) structural analysis and (iii) critical interpretation and discussion. The theoretical framework reflects aspects of behavioural theory of social cognitive theory developed by Albert Bandura and his concept of self-efficacy. RESULTS The findings are presented as themes extracted from the structural analysis and interpreted in the critical interpretation and express the way in which cardiovascular patients experience participating in a sexual rehabilitation programme. Three themes were identified reflecting the intervention to be a special place of understanding, describing the intervention as a supporting atmosphere and finally expressing the intervention as empowering sexuality. CONCLUSIONS Participating in the sexual rehabilitation programme was experienced as efficient, valuable, motivating and safe, but dependent on a professional setting. The intervention developed participants' self-efficacy with regard to their sexual performance and relationship. RELEVANCE TO CLINICAL PRACTICE The findings highlight the importance of a professional setting including certain competencies such as humour and professional skills when handling the after-care of cardiovascular patients with sexual problems.
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Affiliation(s)
- Pernille Palm
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ann-Dorthe Zwisler
- The National Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Jesper Hastrup Svendsen
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annamaria Giraldi
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Sexological Clinic, Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Gjengedal E, Sviland R, Moi AL, Ellingsen S, Flinterud SI, Sekse RJT, Natvik E, Råheim M. Patients’ quest for recognition and continuity in health care: time for a new research agenda? Scand J Caring Sci 2019; 33:978-985. [DOI: 10.1111/scs.12696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Eva Gjengedal
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - Randi Sviland
- Department of Health and Functioning Western Norway University of Applied Sciences Bergen Norway
| | - Asgjerd Litleré Moi
- Department of Health and Caring Sciences Western Norway University of Applied Sciences Bergen Norway
- Department of Plastic Surgery and Burn Center Haukeland University Hospital Bergen Norway
| | - Sidsel Ellingsen
- Faculty of Health Studies VID Specialized University Bergen Norway
| | - Stine Irene Flinterud
- Centre of Diaconia and Professional Practice VID Specialized University Bergen Norway
| | - Ragnhild Johanne Tveit Sekse
- Department of Clinical Science University of Bergen Bergen Norway
- Department of Obstetrics and Gynaecology Haukeland University Hospital Bergen Norway
| | - Eli Natvik
- Department of Health and Caring Sciences Western Norway University of Applied Sciences Førde Norway
| | - Målfrid Råheim
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
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9
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Return to the workforce following infective endocarditis-A nationwide cohort study. Am Heart J 2018; 195:130-138. [PMID: 29224640 DOI: 10.1016/j.ahj.2017.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/08/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND The ability to return to work after infective endocarditis (IE) holds important socioeconomic consequences for both patients and society, yet data on this issue are sparse. We examined return to the workforce and associated factors in IE patients of working age. METHODS Using Danish nationwide registries, we identified 1,065 patients aged 18-60 years with a first-time diagnosis of IE (1996-2013) who were part of the workforce prior to admission and alive at discharge. RESULTS One year after discharge, 765 (71.8%) patients had returned to the workforce, 130 (12.2%) were on paid sick leave, 76 (7.1%) received disability pension, 23 (2.2%) were on early retirement, 65 (6.1%) had died, and 6 (0.6%) had emigrated. Factors associated with return to the workforce were identified using multivariable logistic regression. Younger age (18-40 vs 56-60 years; odds ratio, 2.85; 95% CI, 1.71-4.76) and higher level of education (higher educational level vs basic school; 5.47, 2.05-14.6) and income (highest quartile vs lowest; 3.17, 1.85-5.46) were associated with return to the workforce. Longer length of hospital stay (>90 vs 14-30 days; 0.16, 0.07-0.38); stroke during IE admission (0.38, 0.21-0.71); and a history of chronic kidney disease (0.29, 0.11-0.75), chronic obstructive pulmonary disease (0.31, 0.13-0.71), and malignancy (0.39, 0.22-0.69) were associated with a lower likelihood of returning to the workforce. CONCLUSIONS Seven of 10 patients who were part of the workforce prior to IE and alive at discharge were part of the workforce 1 year later. Younger age, higher socioeconomic status, and absence of major comorbidities were associated with return to the workforce.
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Suárez Bagnasco M, Núñez-Gil IJ. Infective endocarditis and thoracic aortic disease: A review on forgotten psychological aspects. World J Cardiol 2017; 9:620-628. [PMID: 28824792 PMCID: PMC5545146 DOI: 10.4330/wjc.v9.i7.620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/16/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To summarize the current evidence on psychological issues in thoracic aortic disease (TAD) and infective endocarditis (IE) setting.
METHODS We performed a narrative review about psychological issues in adults with IE and TAD. Through the electronic databases, PubMed and PsycINFO, we searched full manuscripts in English and published until September 1, 2014.
RESULTS We found sixteen studies exploring psychological issues in patients with IE (six studies) and in TAD (ten papers). Psychological issues assessed were quality of life, depression, anxiety and posttraumatic stress disorder. Quality of life was explored in IE (four papers) and in TAD (eight papers). Depression and anxiety were analyzed in TAD only (five papers). Post-traumatic stress disorder was assessed in IE (one study). Quality of life was found impaired in three of four studies about IE and in three of eight studies about TAD. Posttraumatic stress disorder was present in 11% and was associated with lower levels of quality of life in IE patients. In TAD patients, anxiety and depression levels after different invasive interventions did not differ.
CONCLUSION Sixteen studies report about psychological issues in IE and TAD. Most of them explore quality of life and to a less extent anxiety and depression.
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Berg SK, Rasmussen TB, Thrysoee L, Lauberg A, Borregaard B, Christensen AV, Ekholm O, Juel K, Svanholm JR. DenHeart: Differences in physical and mental health across cardiac diagnoses at hospital discharge. J Psychosom Res 2017; 94:1-9. [PMID: 28183396 DOI: 10.1016/j.jpsychores.2017.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/22/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe: (i) differences in patient reported physical and mental health outcomes at hospital discharge between a) cardiac diagnostic groups and b) cardiac patients and a national representative reference population and to describe (ii) in-hospital predicting factors for patient reported outcomes. METHODS A national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n=34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate. 16,712 patients (51%) responded; 67% male and mean age 64years. All diagnostic groups were represented similar to real life proportions. Patient reported outcome measures included: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire, HeartQoL and Edmonton Symptom Assessment Scale. RESULTS Statistically significant differences were found in all patient reported outcomes across diagnostic groups. Listed from worst to best outcomes were heart failure, heart valve disease, ischemic heart disease, infectious heart disease, arrhythmia, congenital heart disease and heart transplant. Also "observation for cardiac disease" scored poorly on some aspects such as anxiety and treatment control. Compared to the reference population, cardiac patients had lower physical and mental health scores. Predicting factors for worse outcomes across diagnoses were female sex, older age, being unmarried, planned admission, longer hospital stay, and higher co-morbidity score. CONCLUSIONS This large nationwide study finds significant differences in patient reported outcomes across cardiac diagnostic groups, however the differences were small and did not reach minimal important difference. The total population of cardiac patients had significant and clinically relevant poorer scores on mental and physical health than the reference population. Predicting factors for poor outcomes were identified. It is the first study comparing all diagnostic groups within cardiology and it provides important benchmarks between diagnostic groups and future comparisons. This knowledge may help clinicians make better decisions about post-hospital care and prevention.
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Affiliation(s)
- Selina Kikkenborg Berg
- Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Trine Bernholdt Rasmussen
- Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark
| | - Lars Thrysoee
- Department of Cardiology, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Astrid Lauberg
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Cardiothoracic Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Britt Borregaard
- Cardiothoracic- and Vascular Department, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark
| | - Anne Vinggaard Christensen
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen, Denmark
| | - Jette Rolf Svanholm
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Blv. 99, 8200 Aarhus N, Denmark
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12
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Rasmussen TB, Zwisler AD, Thygesen LC, Bundgaard H, Moons P, Berg SK. High readmission rates and mental distress after infective endocarditis - Results from the national population-based CopenHeart IE survey. Int J Cardiol 2017; 235:133-140. [PMID: 28262341 DOI: 10.1016/j.ijcard.2017.02.077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 01/03/2017] [Accepted: 02/20/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge, (ii) to examine associations between self-reported health and readmission, and (iii) to investigate predictors of readmission and mortality. METHODS All adults treated for IE in Denmark, January-June 2011 (N=347), were followed in registers. Eligible individuals (n=209) were invited to participate in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated. RESULTS Patients discharged after treatment for IE had a mortality of 18% (95% confidence interval (CI): 14%-23%) one year post-discharge and 65% (95% CI: 59%-71%) had been readmitted, the majority (82%) acutely. Patients had lower self-reported health compared to the background population (physical component scale (PCS); mean (standard deviation (SD)): 42.2 (11.1) vs. 47.1 (12.1), (p=0.0004), mental component scale (MCS); 50.1 (11.7) vs. 53.8 (9.2), (p=0.006), and more were sedentary (29 vs. 15%), (p=0.002). Large proportions had clinical signs of anxiety and depression, 25% and 22% respectively, exceeding a hospital anxiety and depression scale (HADS) cut-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). CONCLUSIONS After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management.
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Affiliation(s)
- Trine Bernholdt Rasmussen
- The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark; Department of Cardiology (Section SA-835), Herlev and Gentofte University Hospital, Kildegårdsvej 28, 2900 Hellerup, Denmark.
| | - Ann-Dorthe Zwisler
- National Centre of rehabilitation and palliation, University of Southern Denmark, Vestergade 17, 5800 Nyborg, Denmark.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 1353 Copenhagen K, Denmark.
| | - Henning Bundgaard
- The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, blok D, box 7001, 3000 Leuven, Belgium; Institute of Health and Care Science, University of Gothenburg, Arvid Wallgrens backe 20, 41346 Gothenburg, Sweden.
| | - Selina Kikkenborg Berg
- The Heart Centre (Section 2151), Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
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13
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Abstract
Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with health care contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system. Once established, IE can involve almost any organ system in the body. The diagnosis of IE may be difficult to establish and a strategy that combines clinical, microbiological and echocardiography results has been codified in the modified Duke criteria. In cases of blood culture-negative IE, the diagnosis may be especially challenging, and novel microbiological and imaging techniques have been developed to establish its presence. Once diagnosed, IE is best managed by a multidisciplinary team with expertise in infectious diseases, cardiology and cardiac surgery. Antibiotic prophylaxis for the prevention of IE remains controversial. Efforts to develop a vaccine that targets common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.
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Affiliation(s)
- Thomas L Holland
- Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Room 185 Hanes Building, 315 Trent Drive, Durham, North Carolina 27710, USA
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Larry M Baddour
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Arnold S Bayer
- Department of Medicine, David Geffen School of Medicine at UCLA, Torrance, California, USA
| | - Bruno Hoen
- Department of Infectious Diseases, University Hospital of Pointe-Pitre, Pointe-Pitre, France
| | - Jose M Miro
- Infectious Diseases Service, Hospital Clinic - IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Vance G Fowler
- Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Room 185 Hanes Building, 315 Trent Drive, Durham, North Carolina 27710, USA
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA
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14
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Rasmussen TB, Konradsen H, Dixon J, Moons P, Zwisler AD, Berg SK. Validity, reliability and responsiveness of the Body Image Quality of Life Inventory in patients treated for infective endocarditis. Scand J Caring Sci 2016; 31:183-190. [PMID: 26764551 DOI: 10.1111/scs.12318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/13/2015] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVES Suffering through infective endocarditis (IE) can drastically alter a person's physical appearance, and body image-related concerns have been reported by patients. The extent and severity of the phenomenon has not previously been explored, as no quantitative measure has been validated in this patient population. The purpose of this study was thus to assess the validity, reliability and responsiveness of the Danish Body Image Quality of Life Inventory (BIQLI-DA) on patients treated for IE. METHODS We evaluated the psychometric properties of the BIQLI-DA on data obtained in the CopenHeart IE trial, which is a randomised clinical trial evaluating the effects of comprehensive cardiac rehabilitation for patients treated for IE. We administered the BIQLI-DA as part of data collection at baseline and 6 months. We examined the psychometric properties through correlations to other measures, including body mass index, Medical Outcome Short Form 36 and Hospital Anxiety and Depression Scale. In addition, we examined internal consistency on item and scale level and performed anova group-by-time interaction to test for responsiveness. RESULTS AND STUDY LIMITATION Participants were seventy patients with a mean age of 58 years and of which 83% were men. Results indicated convergent construct validity by confirming hypothesised associations to potentially related constructs. The BIQLI-DA was found to be highly internally consistent with a Cronbach's alpha of 0.96. Instrument responsiveness was indicated by a significant group-by-time interaction. Support for the validity of the BIQLI-DA might have been strengthened by a larger sample with more women. A more optimal design for testing responsiveness would possibly have allowed for clearer conclusions. CONCLUSIONS The BIQLI-DA may be applicable in healthcare research as it seems to be valid, reliable and responsive; however, evidence should be strengthened through further exploration of instrument performance, particularly regarding responsiveness.
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Affiliation(s)
- Trine Bernholdt Rasmussen
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
| | - Hanne Konradsen
- Research Unit, Gentofte University Hospital, Hellerup, Denmark
| | - Jane Dixon
- Yale University School of Nursing, Orange, CT, USA
| | - Philip Moons
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Centre for Health Services and Nursing Research, University of Leuven, Leuven, Belgium.,Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden
| | - Ann-Dorthe Zwisler
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Odense, Denmark.,National Centre of rehabilitation and palliation, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Selina Kikkenborg Berg
- The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
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