Management of endocarditis among persons who inject drugs: A narrative review of surgical and psychiatric approaches and controversies.

摘要: Abstract Background People who inject drugs (PWID) represent a high-risk subgroup of endocarditis patients. This is highlighted by poorer post-operative outcomes in injection drug use-related infective (IDU-IE), which largely attributable to the increased vulnerability prosthetic valves re-infection. Consequently, many centres do not perform valve replacement on these A parallel, but often underrecognized, component care role multidisciplinary management for individuals with IDU-IE, including perioperative addictions and psychiatric care. surgical options IDU-IE remain controversial topic. Objectives To determine characteristics optimal IDU-IE. Methods We conducted narrative synthesis findings literature retrieved from searches computerized databases, hand searches, authoritative text, organizing into several key themes: clinical factors associated mortality alternative options, risk stratification techniques, principles ethical considerations controversies, future research directions. Results/conclusions Managing involves treatment two comorbidities: intra-cardiac infection underlying substance use disorder. Cardiac surgery represents high-intensity intervention appreciable risk, benefit it always clear. As patients present acutely, feasible abstinence as prerequisite surgery. Involvement inpatient psychiatry teams, however, appears be an evidence-based approach that can bridge opioid agonist therapy hospital adequate outpatient their addiction upon discharge hospital. It likely majority are receiving despite increasing recognition efficacy. Further interdisciplinary studies needed elucidate protocols. Infective (IE) innermost lining heart affecting valves. Over last few decades, epidemiology IE has shifted developed world while continues significant cause morbidity mortality, there been incidence among persons (PWID). date, well-conducted epidemiologic PWID have sparse, limited our ability fully characterize this disease phenomenon. address knowledge deficit, we organized six