Endocarditis, Stroke
Conditions
Keywords
Neurological assessment, Medical care
Brief summary
Infectious endocarditis (IE) is a serious condition with an annual incidence of 3 to 10 per 100,000 people. Brain infarctions complicate approximately 20-40% of endocarditis. Brain MRI can detect the presence of recent ischemic lesions and asymptomatic microbleeds. Preoperative brain imaging is part of the recommended assessment in the management of IEs, but the type of imaging and sequences are not codified and the impact of cerebral and vascular imaging findings on the therapeutic decision remains uncertain. The level of evidence of the recommendations remains low, especially for complicated IEs of stroke. There is very little neurological clinical data on patients with IEs. Similarly, neurologists do not systematically participate in multidisciplinary meetings during the management of an IE. It therefore seems interesting to carry out a neurological cohort of this population and to evaluate what would be the contribution of vascular neurologists in the management of infectious endocarditis.
Interventions
No specific procedure is planned for the study other than the neurological examination by a neurologist of all patients. The patient will be taken care according to current recommendations. In addition, a study-specific, non-injected brain CT scan will be performed systematically in patients undergoing cardiac surgery to evaluate postoperative hemorrhagic transformation.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients * Certain infectious endocarditis according to Dukes Criteria * Signed informed consent
Exclusion criteria
* Hospital admission due to neurovascular emergency * MRI contraindications * Pregnant or women of childbearing age who were not using contraception (oral diagnosis), * Patient without health coverage, * Patient under legal protection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Medical care modification | at 3 months | Description of the medical care modification after neurological assessment, evaluated by the number of patients with modified medical care by the request for a new examination compared to the initially scheduled care. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The description of the perioperative hemorrhagic risk | 24 to 96 hours post-surgery | Description of the perioperative hemorrhagic risk evaluated by the rate of haemorrhagic transformation on the post-surgery control scanner |
| Prognosis assessment | at 3 months | Evaluation of prognosis by the rate of deaths and stroke |
| The description of the preoperative neurological impairment | During initial hospitalization | Description of preoperative neurological impairment assessed by NIHSS score |
| Evaluation of depressive anxiety disorders | at 3 months | Evaluation of depressive anxiety disorders measured by the Hamilton Anxiety Depression scale |
| Evaluation of the cognitive prognosis | at 3 months | Evaluation of the cognitive prognosis evaluated by the MOCA score |
| Evaluation of functional prognosis | at 3 months | Evaluation of the functional prognosis measured by the mRS score |
Countries
France
Contacts
Primary ContactElodie ONG, Dr
Backup ContactJulia CANTERINI
Outcome results
None listed