Admission to a referral centre and one-year mortality among patients with infective endocarditis in a French multicentre cohort

Infective endocarditis (IE) is a potentially fatal condition. Early consultation with the nearest IE team and timely referral in the event of complications are recommended. This study investigated the association between receiving care in a reference centre and one-year mortality among patients with IE. Patients with definite IE enrolled in the EI 2008 cohort, a prospective population based-study, were categorised into three groups: 1) initially admitted to a reference centre (R); 2) initially admitted to a nonreference centre and subsequently referred to a reference centre (NR-R); and 3) exclusively managed in a nonreference centre (NR). Cox models were used for analysis. In our sample, 496 patients (279 R, 160 NR-R, and 57 NR) were included. Patients in the R and NR-R groups were younger and had a higher rate of indications for cardiac surgery. Overall, 142 patients (28.6%) died during follow-up. Care in a reference centre at any point was not associated with one-year mortality (crude-HR [95% CI]: 0.87 [0.57–1.33], p = 0.518; adjusted-HR 0.98 [0.62–1.56], p = 0.933). Further adjustment for valve surgery did not affect these results (adjusted HR 0.95 [0.59–1.53], p = 0.831). Management at a reference centre was not associated with one-year mortality. Trial registration: NCT03295045.