Imperial College London
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Mr Prakash P Punjabi

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Cardiothoracic Surgery)
 
 
 
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Contact

 

+44 (0)20 3313 2026p.punjabi Website

 
 
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Location

 

BN2/25 B BlockHammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hartley:2021:2021/5565200,
author = {Hartley, A and El-Sayed, A and Abbara, A and Henderson, J and Ghazy, A and Davies, F and Price, JR and Punjabi, P and Anderson, J and Casula, R and Naderi, H and Asaria, P and Sutaria, N and Malik, I and Pabari, P and Rana, B},
doi = {2021/5565200},
journal = {Cardiology Research and Practice},
pages = {1--4},
title = {Restricted use of echocardiography in suspected endocarditis during COVID-19 lockdown: a multidisciplinary team approach},
url = {http://dx.doi.org/10.1155/2021/5565200},
volume = {2021},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Infective endocarditis (IE) is challenging to manage in the COVID-19 lockdown climate, in part given its reliance on echocardiography for diagnosis and management, and the associated virus transmission risks to patients and healthcare workers. This study assesses utilisation of the endocarditis team (ET) in limiting routine echocardiography, especially transoesophageal echocardiography (TOE), in patients with suspected IE, and explores the effect on clinical outcomes.Methods:All patients discussed at the ET meeting at Imperial College Healthcare NHS Trust during the first lockdown in the UK (23rd March – 8th July 2020) were prospectively included and analysed in this observational study.Results:In total, 38 patients were referred for ET review (71% male, median age 54 [interquartile range 48, 65.5] years). At the time of ET discussion, 21% had no echo imaging, 16% had point-of-care ultrasound only and 63% had formal TTE. In total, only 16% underwent TOE. The ability of echocardiography, in those where it was performed, to affect IE diagnosis according to the Modified Duke Criteria was significant (p=0.0099), however, sensitivity was not affected. All-cause mortality was 17% at 30-days and 25% at 12-months from ET discussion in those with confirmed IE.Conclusion:Limiting echocardiography in patients with a low pre-test probability (not probable or definite IE according to the Modified Duke Criteria) did not affect the diagnostic ability of the Modified Duke Criteria to rule out IE in this small study. Moreover, restricting non-essential echocardiography, and importantly TOE, in patients with suspected IE through use of the ET did not impact all-cause mortality.
AU  - Hartley,A
AU  - El-Sayed,A
AU  - Abbara,A
AU  - Henderson,J
AU  - Ghazy,A
AU  - Davies,F
AU  - Price,JR
AU  - Punjabi,P
AU  - Anderson,J
AU  - Casula,R
AU  - Naderi,H
AU  - Asaria,P
AU  - Sutaria,N
AU  - Malik,I
AU  - Pabari,P
AU  - Rana,B
DO  - 2021/5565200
EP  - 4
PY  - 2021///
SN  - 2090-0597
SP  - 1
TI  - Restricted use of echocardiography in suspected endocarditis during COVID-19 lockdown: a multidisciplinary team approach
T2  - Cardiology Research and Practice
UR  - http://dx.doi.org/10.1155/2021/5565200
UR  - https://www.hindawi.com/journals/crp/2021/5565200/
UR  - http://hdl.handle.net/10044/1/90751
VL  - 2021
ER  -
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