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Journal articles
Revisiting the effect of referral bias on the clinical spectrum of infective endocarditis in adults.
Z A Kanafani
S S Kanj
1
C H Cabell
E Cecchi
A de Oliveira Ramos
T Lejko-Zupanc
2
P A Pappas
3
H Giamerellou
D Gordon
4
C Michelet
5
P Muñoz
6
O Pachirat
7
G Peterson
R-S Tan
8
P Tattevin
9
V Thomas
Anqing Wang
F Wiesbauer
D J Sexton
1
AUBMC - American University of Beirut Medical Center (P.O.Box: 11-0236 Riad El Solh, Beirut 1107 2020 Beirut - Lebanon - Lebanon)
- AUB - American University of Beirut [Beyrouth] (P.O.Box 11-0236 Riad El-Solh / Beirut 1107 2020 - Lebanon)
2
University Medical Center Ljubljana (Slovenia)
3
Duke University Medical Center (2301 Erwin Rd, Durham, NC 27710 - United States)
4
Flinders Medical Centre (Bedford Park, Adelaide 5042 - Australia)
- Flinders Medical Centre (Bedford Park, South Australia, 5042 Adelaide - Australia)
5
CHU Pontchaillou [Rennes] (2 Rue Henri le Guilloux, 35000 Rennes - France)
6
Clinical Microbiology and Infectious Diseases Department (Spain)
- UCM - Universidad Complutense de Madrid [Madrid] (Avda. de Séneca, 2, Ciudad Universitaria, 28040 Madrid - Spain)
7
KKU - Khon Kaen University [Thailand] (Nong Khai Campus, 112 M. 7 A., Muang Nong Khai 43000 Thailand - Thailand)
9
Service des maladies infectieuses et réanimation médicale (2 rue Henri Le Guilloux 35033 RENNES cedex 9 - France)
- UR1 - Université de Rennes 1 (2 rue du Thabor - CS 46510 - 35065 Rennes cedex - France)
- UNIV-RENNES - Université de Rennes (France)
- Hôpital Pontchaillou (France)
Abstract : Referral bias occurs because of the clustering of patients at tertiary care centers. This may result in the distortion of observed clinical manifestations of rare diseases. This analysis evaluates the effect of referral bias on the epidemiology of infective endocarditis (IE) in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS). This is a prospective multicenter cohort study comparing transferred and non-transferred patients with IE. Factors independently associated with transfer status were evaluated using multivariable logistic regression. A total of 2,760 patients were included in the analysis, of which 1,164 (42.2%) were transferred from other medical centers. Transferred patients more often underwent surgery for IE (odds ratio [OR] = 2.5; 95% confidence interval [CI] 1.9-3.2). They were also more likely to have complications such as stroke (OR = 1.5; 95% CI 1.3-1.9), heart failure (OR = 1.4; 95% CI 1.1-1.6), and new valvular regurgitation (OR = 1.3; 95% CI 1.1-1.6). The in-hospital mortality rates were similar in both groups. Patients with IE who require surgery and suffer complications are referred to tertiary hospitals more frequently than patients with an uncomplicated course. Hospital transfer has no obvious effect on the in-hospital mortality. Referral bias should be taken into consideration when describing the clinical spectrum of IE.
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Journal articles
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118410
Contributor : Laurent Jonchère <>
Submitted on : Thursday, February 19, 2015 - 9:24:29 AM
Last modification on : Wednesday, August 11, 2021 - 7:02:08 PM
Contributor : Laurent Jonchère <>
Submitted on : Thursday, February 19, 2015 - 9:24:29 AM
Last modification on : Wednesday, August 11, 2021 - 7:02:08 PM
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- HAL Id : hal-01118410, version 1
- PUBMED : 20549531
- DOI : 10.1007/s10096-010-0983-2
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UNIV-RENNES1 | IRSET | BIOSIT | UR1-UFR-SVE | UNIV-RENNES
Citation
Z A Kanafani, S S Kanj, C H Cabell, E Cecchi, A de Oliveira Ramos, et al.. Revisiting the effect of referral bias on the clinical spectrum of infective endocarditis in adults.. European Journal of Clinical Microbiology and Infectious Diseases, Springer Verlag, 2010, 29 (10), pp.1203-10. ⟨10.1007/s10096-010-0983-2⟩. ⟨hal-01118410⟩
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