Assessment of the incidence of infectious endocarditis in Limousin Poitou-Charentes and the buccodental follow-up of high-risk patients.

Aims: To assess the incidence of infectious endocarditis in Limousin Poitou-Charentes in 2000 and to study the buccodental health of high-risk patients and improve their follow-up. Method: We performed a two-part, retrospective, cross-sectional study. In the first part, by using the computer program for hospitalization medical records (PMSI), we looked for all patients who were hospitalized for infectious endocarditis in 2000 in Limousin Poitou-Charentes and determined the incidence of the disease. In the second part, we performed a buccodental examination of all the volunteer patients who were waived from co-payments for a cardiac disease carrying a risk for infectious endocarditis and who had not filed a reimbursement request for any buccodental care between September 1, 2000 to August 31, 2001. Results: The regional incidence of infectious endocarditis was 57.4 cases/1,000,000 inhabitants/year. In 13% of the 135 patients who had been hospitalized for this disorder, the infection had a buccodental origin. The total regional cost for initial hospital care related to endocarditis was estimated to be 12,127 € per patient. Among the 4,460 high-risk patients, 2,379 (53.3 %) had not filed a reimbursement request for dental care during the course of the preceding year. Only 544 patients accepted to be examined by the medical service; 74,8 % of them had poor bucodental health. Conclusion: This study confirms the relative increase in infectious endocarditis occurring in healthy hearts and the reduction in the role played by a buccodental origin and in overall mortality. The average cost for initial hospital care was lower than data seen in previously published literature. We undertook incentives to improve the buccodental follow-up of patients in the region