Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2017 |
|---|---|
| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
|---|---|
| Enthalten in: |
Cardiovascular diagnosis and therapy - 7(2017), 1 vom: 10. Feb., Seite 27-35 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cresti, Alberto [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Community-acquired endocarditis |
|---|
| Anmerkungen: |
Date Revised 12.11.2023 published: Print Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.21037/cdt.2016.08.09 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM268681619 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM268681619 | ||
| 003 | DE-627 | ||
| 005 | 20231224223108.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2017 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.21037/cdt.2016.08.09 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0895.xml |
| 035 | |a (DE-627)NLM268681619 | ||
| 035 | |a (NLM)28164010 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Cresti, Alberto |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study |
| 264 | 1 | |c 2017 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 12.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Infective endocarditis (IE) | |
| 650 | 4 | |a community-acquired endocarditis | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a health-care associated endocarditis | |
| 650 | 4 | |a temporal trends | |
| 700 | 1 | |a Chiavarelli, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Scalese, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Nencioni, Cesira |e verfasserin |4 aut | |
| 700 | 1 | |a Valentini, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Guerrini, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a D'Aiello, Incoronata |e verfasserin |4 aut | |
| 700 | 1 | |a Picchi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a De Sensi, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Habib, Gilbert |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cardiovascular diagnosis and therapy |d 2011 |g 7(2017), 1 vom: 10. Feb., Seite 27-35 |w (DE-627)NLM22814731X |x 2223-3652 |7 nnns |
| 773 | 1 | 8 | |g volume:7 |g year:2017 |g number:1 |g day:10 |g month:02 |g pages:27-35 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.21037/cdt.2016.08.09 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 7 |j 2017 |e 1 |b 10 |c 02 |h 27-35 | ||