Incidence and mortality of infective endocarditis in the last decade: a single center study

Abstract

Background Infective endocarditis (IE) is a significant disease characterized by high mortality and complications. The aim of this study was to evaluate the incidence/100 000 inhabitants and the in-hospital mortality/100 000 inhabitants of IE during the last 10 years in the province of Ravenna. Methods and resultsWe reviewed the public hospitals discharge database from January 2010 to December 2020 using the international classification of disease codification (ICD-9) for IE. We used the Italian national statistical institute (ISTAT) archive to estimate the number of Ravenna inhabitants/year. In 10 years, we identified a total of 407 patients with diagnosis of IE.The incidence of IE increased significantly from 6.29 cases/ 100 000 inhabitants in 2010 to 19.58 cases/100 000 inhabitants in 2020 (P < 0.001). Also, the in-hospital mortality from IE increased over the same number of years, from 1.8 deaths/100 000 inhabitants in 2010 to 4.4 deaths/ 100 000 inhabitants in 2020 (P < 0.001). The mortality rate (%) of IE over the years did not increase (P U 0.565). Also, over the years there was no difference in the site of infection (P U 0.372), irrespective of the valve localization or type, native valve (P U 0.347) or prosthetic valve (P U 0.145). On logistic regression analysis, age was the only predictor of in-hospital mortality (odds ratio 1.045, 95% confidence interval: 1.015; 1.075, P U 0.003)Conclusions Ravenna-based data on IE showed increased disease incidence but unchanged mortality rate over 10 years of follow-up. Age remains the sole predictor of populationbased mortality, irrespective of the nature of the valve, native or substitute, and the organism detected on microbiology.

ObsErvatioNal prospective multicenter stuDy tO characterize the cLinical ANd DiagnoStiC feAtures of endocarditis in the contemPorary Era (ENDO-LANDSCAPE study): rationale and design

“…Furthermore, the changing pathogenesis and virulence of organisms, particularly in patients with implanted valves or devices have increased the complexity of treatment. 11,12 Increasingly, requirement for nonstandard antibiotic treatment regimens, in combination with critical illness in elderly and frail patients has resulted in complex decision-making and management approaches. The role and value of a multidisciplinary team in these instances particularly in determining decisions for surgical intervention and timing of the intervention are becoming increasingly apparent.…”

“…Computed tomography (CT) imaging, especially in the context of suspected or confirmed embolic complications, 10 and hybrid nuclear imaging, that is, PET-CT and SPECT-CT have been demonstrated to significantly improve diagnostic accuracy where more traditional approaches have failed to detect presence of endocarditis. Furthermore, the changing pathogenesis and virulence of organisms, particularly in patients with implanted valves or devices have increased the complexity of treatment 11,12 . Increasingly, requirement for nonstandard antibiotic treatment regimens, in combination with critical illness in elderly and frail patients has resulted in complex decision-making and management approaches.…”

Cerebral Thrombus Analysis in Infective Endocarditis: Unveiling Composition for Diagnostic Insight

“…Clinical outcome after IE has shown limited improvement over the last decades 9, 10 . This is partly due to the incomplete understanding of the precise pathological mechanisms and the complex interplay of microorganism virulence, coagulation processes, and immune response, which contribute to the formation, growth, and embolization of endocarditic vegetations.…”

Understanding Bartonella-Associated Infective Endocarditis: Examining Heart Valve and Vegetation Appearance and the Role of Neutrophilic Leukocytes

“…Infective endocarditis (IE) is a severe infectious disease that affects the heart’s endocardium and cardiac valves. The incidence of IE has increased two-fold over the last two decades [ 1 ], with the annual incidence being around 3–19/100,000 of the population [ 1 , 2 ]. Despite the use of effective antimicrobial therapy, the mortality rate of IE patients remains unacceptably high—up to 30% in 30 days to 1 year [ 2 , 3 ].…”

“…The incidence of IE has increased two-fold over the last two decades [ 1 ], with the annual incidence being around 3–19/100,000 of the population [ 1 , 2 ]. Despite the use of effective antimicrobial therapy, the mortality rate of IE patients remains unacceptably high—up to 30% in 30 days to 1 year [ 2 , 3 ]. The most common complications of IE are congestive heart failure, paravalvular abscess formation, and embolism [ 4 ].…”