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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
110
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.
Stroke Unit, Pierre Wertheimer hospital, GHE Hospices Civils de Lyon
Bron, France
RECRUITINGMedical care modification
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.
Time frame: at 3 months
Medical care modification
Description of the medical care modification after neurological assessment, evaluated by the number of patients with modified medical care by the change of therapy compared to the initially scheduled care.
Time frame: at 3 months
The description of the preoperative neurological impairment
Description of preoperative neurological impairment assessed by NIHSS score
Time frame: During initial hospitalization
The description of the preoperative neurological impairment
Description of preoperative neurological impairment assessed by the presence of brain lesions on initial MRI
Time frame: During initial hospitalization
The description of the perioperative hemorrhagic risk
Description of the perioperative hemorrhagic risk evaluated by the rate of haemorrhagic transformation on the post-surgery control scanner
Time frame: 24 to 96 hours post-surgery
Prognosis assessment
Evaluation of prognosis by the rate of deaths and stroke
Time frame: at 3 months
Evaluation of functional prognosis
Evaluation of the functional prognosis measured by the mRS score
Time frame: at 3 months
Evaluation of depressive anxiety disorders
Evaluation of depressive anxiety disorders measured by the Hamilton Anxiety Depression scale
Time frame: at 3 months
Evaluation of the cognitive prognosis
Evaluation of the cognitive prognosis evaluated by the MOCA score
Time frame: at 3 months
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