[Infectious endocarditis: degree of discordance between clinical guidelines recommendations and clinical practice].
OBJECTIVE
The present study was made to investigate the degree of discordance between the recommendations of clinical guidelines and actual practice in the care of patients with infectious endocarditis.


METHODS
Data was gathered on 34 patients that were admitted to our hospital for native valve infection over a 4-year period. The degree of discordance (%) was obtained by comparing each clinical history with a catalog of 15 specific actions recommended in the clinical guidelines for four consecutive phases: pre-diagnosis, hospital diagnosis, antibiotic treatment, and surgical treatment. A system was constructed, scoring each phase with the greatest detected error (on a severity scale of 0 to 8 points) and adding together the scores for the four phases.


RESULTS
The mean degree of discordance was 30.5% (range, 0-66%). Scores of more than six points were clearly associated with an unfavourable evolution.


CONCLUSIONS
The recommendations of clinical guidelines for infectious endocarditis are inadequately followed in practice, which can affect the course of the disease. It is necessary to increase adherence to clinical guidelines in practice, in order to improve the care of patients with this serious disease.
Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Mercedes
M
González De Molina
Juan C
JC
Fernández-Guerrero
José
J
Azpitarte
D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D013030:Spain; D013997:Time Factors