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Cresti A, Chiavarelli M, Scalese M, et al. Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study. Cardiovasc Diagn Ther. 2017;7(1):27-35doi: 10.21037/cdt.2016.08.09.
Cresti, A., Chiavarelli, M., Scalese, M., Nencioni, C., Valentini, S., Guerrini, F., D'Aiello, I., Picchi, A., De Sensi, F., & Habib, G. (2017). Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study. Cardiovascular diagnosis and therapy, 7(1), 27-35. https://doi.org/10.21037/cdt.2016.08.09
Cresti, Alberto, et al. "Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study." Cardiovascular diagnosis and therapy vol. 7,1 (2017): 27-35. doi: https://doi.org/10.21037/cdt.2016.08.09
Cresti A, Chiavarelli M, Scalese M, Nencioni C, Valentini S, Guerrini F, D'Aiello I, Picchi A, De Sensi F, Habib G. Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study. Cardiovasc Diagn Ther. 2017 Feb;7(1):27-35. doi: 10.21037/cdt.2016.08.09. PMID: 28164010; PMCID: PMC5253443.
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Cardiovasc Diagn Ther. 2017 Feb;7(1):27-35. doi: 10.21037/cdt.2016.08.09.

Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study.

Cardiovascular diagnosis and therapy

Alberto Cresti, Mario Chiavarelli, Marco Scalese, Cesira Nencioni, Silvia Valentini, Francesco Guerrini, Incoronata D'Aiello, Andrea Picchi, Francesco De Sensi, Gilbert Habib

Affiliations

  1. Cardiological Department, Misericordia Hospital, Grosseto, Italy.
  2. Division of Cardiothoracic Surgery, Department of Surgery, Le Scotte Hospital, Siena University, Siena, Italy.
  3. Department of Epidemiology and Health Research, Institute of Clinical Physiology, National Council of Research, F. G. Monasterio, Pisa, Italy.
  4. Infectious Disease Department Misericordia Hospital, Grosseto, Italy.
  5. Cardiology Department, Hôpital La Timone, Marseille, France.

PMID: 28164010 PMCID: PMC5253443 DOI: 10.21037/cdt.2016.08.09

Abstract

BACKGROUND: The population at risk, the clinical and microbiological features of infective endocarditis (IE) have changed. Aim of our study was to evaluate the contemporary epidemiological trends, over a 17-year period in a definite region of Tuscany, Italy, to analyze the clinical outcomes and associated prognostic factors.

METHODS: From 1 January 1998 to 31 December 2014, all patients with a definite diagnosis of IE were prospectively entered in a data-base. The Health-Care system data-base was interrogated to capture patients who could have been missed. The final dataset derived by the merging of the two data-bases.

RESULTS: Incidence rate of IE was 4.6/100,000/y with a significant linear incidence increase. In hospitalized patients the incidence was 1.27/1,000 admissions. Over age 65 incidence rate was 11.7/100,000/y. Male/female ratio was 1.54:1. A temporal trend towards an increase in the mean population age was found (P=0.033). There was an increase in the incidence of Health-care associated IE, P=0.016. The most common microorganisms were staphylococcus aureus (25%) and coagulase-negative staphylococci (22%). In-hospital mortality was 24%. A trend towards an increase in mortality rate was found (P=0.055). Independent predictors of mortality were older age, S. aureus infection, heart failure, septic shock and persistent bacteremia.

CONCLUSIONS: Our study confirms an increasing mortality trend in IE, although with a borderline significance. Elderly forms are associated with poor prognosis and higher than 1-year mortality rate even in the multivariate analysis. Ageing population, increase in healthcare-associated and staphylococcal infections, may explain the rise of IE incidence and of the mortality trend.

Keywords: Infective endocarditis (IE); community-acquired endocarditis; epidemiology; health-care associated endocarditis; temporal trends

Conflict of interest statement

The authors have no conflicts of interest to declare.

References

  1. JAMA. 2002 Jul 3;288(1):75-81 - PubMed
  2. JAMA. 2005 Jun 22;293(24):3012-21 - PubMed
  3. N Engl J Med. 2004 Apr 1;350(14):1422-9 - PubMed
  4. Am Heart J. 2012 Jul;164(1):94-101 - PubMed
  5. Clin Infect Dis. 2000 Apr;30(4):633-8 - PubMed
  6. Arch Intern Med. 2009 Mar 9;169(5):463-73 - PubMed
  7. J Am Coll Cardiol. 2015 May 19;65(19):2070-6 - PubMed
  8. Chest. 2007 Sep;132(3):1025-35 - PubMed
  9. Heart. 2005 May;91(5):571-5 - PubMed
  10. Am J Med. 1994 Mar;96(3):200-9 - PubMed
  11. Circulation. 2008 Aug 19;118(8):887-96 - PubMed
  12. Glob Heart. 2014 Mar;9(1):131-43 - PubMed
  13. Lancet. 2004 Jan 10;363(9403):139-49 - PubMed
  14. Ann Intern Med. 2009 May 5;150(9):586-94 - PubMed
  15. Heart. 2006 Jul;92(7):879-85 - PubMed
  16. Eur Heart J. 2009 Oct;30(19):2369-413 - PubMed
  17. Heart. 1997 Mar;77(3):260-3 - PubMed
  18. Arch Intern Med. 2007 Apr 9;167(7):669-75 - PubMed
  19. Eur J Clin Microbiol Infect Dis. 2010 Oct;29(10):1203-10 - PubMed
  20. N Engl J Med. 2012 Aug 30;367(9):842-9 - PubMed
  21. Eur Heart J. 2010 Aug;31(15):1890-7 - PubMed
  22. Lancet. 2015 Mar 28;385(9974):1219-28 - PubMed
  23. Heart. 2007 Jan;93(1):5-6 - PubMed
  24. Mayo Clin Proc. 2000 Oct;75(10):1008-14 - PubMed
  25. Arch Intern Med. 2008 Oct 27;168(19):2095-103 - PubMed
  26. Eur Heart J. 2015 Nov 21;36(44):3075-128 - PubMed
  27. BMC Infect Dis. 2013 Nov 15;13:545 - PubMed
  28. Am Heart J. 2004 Apr;147(4):582-6 - PubMed
  29. BMC Infect Dis. 2011 Feb 23;11:48 - PubMed
  30. J Am Coll Cardiol. 2012 May 29;59(22):1968-76 - PubMed
  31. Eur Heart J. 2007 Jan;28(2):196-203 - PubMed

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