Boston University Libraries OpenBU
    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    •   OpenBU
    • Theses & Dissertations
    • Boston University Theses & Dissertations
    • View Item
    •   OpenBU
    • Theses & Dissertations
    • Boston University Theses & Dissertations
    • View Item

    Prognostic factors in infective endocarditis

    Thumbnail
    Date Issued
    2016
    Author(s)
    Grzybinski, Sarah
    Share to FacebookShare to TwitterShare by Email
    Export Citation
    Download to BibTex
    Download to EndNote/RefMan (RIS)
    Metadata
    Show full item record
    Permanent Link
    https://hdl.handle.net/2144/19176
    Abstract
    BACKGROUND: Infective endocarditis (IE) is an infectious disease, most often bacterial in etiology, which affects the endocardial tissue layer of the heart. Despite advances in diagnostic technology, surgical technique, and antimicrobial therapy, IE remains a high-mortality disease. OBJECTIVE: This is a proposed quality improvement initiative for the Boston Medical Center (BMC) inpatient medicine service. The initiative aims to identify predictors of mortality in patients with IE, and then use the predictors to create a mortality risk-assessment checklist. The checklist will serve as a clinical tool for medicine service providers to help determine if upgrade to ICU level of care is warranted. With early upgrade to an ICU setting, patients with a high risk of mortality will receive more individualized care and expedited medical intervention. The goal of this quality improvement initiative is to decrease mortality rate in patients with IE at BMC. METHODS: This quality improvement initiative will implement the PDSA (plan, do, study, act) model for quality improvement. The checklist will be integrated into the electronic health record system at BMC and will be implemented over a two-year time period. Each PDSA cycle will last one year, and between PDSA cycles the checklist will be modified according to medical provider feedback. The data will be gathered through chart reviews to determine pre and post-checklist differences in number of transfers to the ICU and overall mortality rates of IE patients at BMC. RESULTS: The literature review of this proposed quality improvement initiative has identified nine independent risk factors for mortality in patients with IE: Staphylococcus aureus as infective organism, New York Heart Association class IV heart failure, left ventricular ejection fraction < 40%, vegetation size ≥ 15 mm, age > 50 years, diabetes mellitus, peripheral dermatologic findings on physical examination, serum neutrophil-to-lymphocyte ratio > 5.45, and serum D-dimer level > 4.0 mg/L. CONCLUSION: If medical providers had access to a risk assessment tool to help identify IE patients with a high risk of mortality, they could more accurately determine appropriate level of care, expedite medical intervention, and possibly reduce rates of in-hospital death in patients with IE.
    Collections
    • Boston University Theses & Dissertations [6897]


    Boston University
    Contact Us | Send Feedback | Help
     

     

    Browse

    All of OpenBUCommunities & CollectionsIssue DateAuthorsTitlesSubjectsThis CollectionIssue DateAuthorsTitlesSubjects

    Deposit Materials

    LoginNon-BU Registration

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Boston University
    Contact Us | Send Feedback | Help