Incidence, Microbiology, and Outcomes in Patients Hospitalized With Infective Endocarditis

Shah, Anoop; McAllister, David; Gallacher, Peter J.; Astengo, F; Perez, Jesus A. Rodriguez; Hall, Jennifer; Lee, Kuan Ken; Bing, Rong; Anand, Atul; Nathwani, Dilip; Mills, Nicholas L; Newby, David E.; Marwick, Charis; Cruden, Nicholas L.

doi:10.1161/circulationaha.119.044913

Cited by 109 publications

(138 citation statements)

References 44 publications

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“…Regarding microbiology, the data retrieved from discharge notes were scarce (49.5% of the total cohort), probably a result of underreporting—this has been noted in other populational studies such as in Fedeli et al [ 18 ] or Shah et al [ 27 ]. Infectious agents such as Staphylococcus spp.…”

Section: Discussionmentioning

confidence: 95%

“…With regards to IE, populational surveys are scarce and with significant variations regarding methodology and results. The reported incidence of IE among different studies is not entirely similar ranging between 3 and 15 cases per 100,000 in population-based studies [ 15 – 27 ], with considerable differences noted even in similar countries [ 28 ]. Still, the findings in Portugal are consistent with the already described values.…”

Section: Discussionmentioning

confidence: 99%

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Insight into the epidemiology of infective endocarditis in Portugal: a contemporary nationwide study from 2010 to 2018

Sousa

Nogueira

Pinto

2021

BMC Cardiovasc Disord

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Background Nationwide hospital admissions data series have contributed to a reliable assessment of the changing epidemiology of infective endocarditis, even though conclusions are not uniform. We sought to use a recent populational series to describe the temporal trends on the incidence of infective endocarditis, its clinical characteristics and outcome results, in Portugal. Methods A nationwide retrospective temporal trend study on the incidence and clinical characterization of patients hospitalized with infective endocarditis, between 2010 and 2018. Results 7574 patients were hospitalized with infective endocarditis from 2010 to 2018 in Portuguese public hospitals. The average length of hospitalization was 29.3 ± 28.7 days, predominantly men (56.9%), and 47.1% had between 60 and 79 years old. The most frequent infectious agents involved were Staphylococcus (16.4%) and Streptococcus (13.6%). During hospitalization, 12.4% of patients underwent heart valve surgery and 20% of the total cohort died. After a 1-year post-discharge follow-up, 13.2% of the total initial cohort had had heart valve surgery and 21.2% in total died. The annual incidence of infective endocarditis was 8.31 per 100,000 habitants, being higher in men (9.96 per 100,000 in males versus 6.82 in females, p < 0.001) and increased with age, peaking at patients 80 years old or older (40.62 per 100,000). In-hospital mortality rate significantly increased during the analyzed period, the strongest independent predictors being ischemic or hemorrhagic stroke, sepsis, and acute renal failure. Younger age and cardiac surgery had a protective effect towards a fatal outcome. Conclusions In Portugal, between 2010 and 2018, the incidence of infective endocarditis presented a general growth trend with a deceleration in the most recent years. Also, a significant rate of in-hospital complications, a mildly lower than expected stable surgical rate and a still high and growing mortality rate were noted.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Insight into the epidemiology of infective endocarditis in Portugal: a contemporary nationwide study from 2010 to 2018

Sousa

Nogueira

Pinto

2021

BMC Cardiovasc Disord

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“…Firstly, the overwhelming majority of healthcare (especially acute care) is directly delivered by the National Health Service (NHS), which also maintains a national database on all directly employed staff in Scotland, including nursing, medical, and support staff and allied health professionals. Secondly, Scotland has a well established health record linkage system 678…”

Section: Introductionmentioning

confidence: 99%

Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study

Shah

Wood

Gribben

et al. 2020

BMJ

302

282

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ObjectiveTo assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members.DesignNationwide linkage cohort study.SettingScotland, UK, 1 March to 6 June 2020.ParticipantsHealthcare workers aged 18-65 years, their households, and other members of the general population.Main outcome measureAdmission to hospital with covid-19.ResultsThe cohort comprised 158 445 healthcare workers, most of them (90 733; 57.3%) being patient facing, and 229 905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in “front door,” intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity.ConclusionsHealthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.

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“…Secondly, Scotland has a well-established health record linkage system. [6][7][8] Using record linkage, we evaluated the risk of COVID-19 hospitalisation in healthcare workers in patient and non-patient facing roles along with the risk of their household members. We further evaluated the risk of COVID-19 hospitalisation in patient facing healthcare workers in different clinical settings including intensive care and front-door departments.…”

Section: Introductionmentioning

confidence: 99%

Risk of hospitalisation with coronavirus disease 2019 in healthcare workers and their households: a nationwide linkage cohort study

Shah

Wood

Gribben

et al. 2020

Preprint

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Objective: Many healthcare staff work in high-risk settings for contracting and transmitting Severe Acute Respiratory Syndrome Coronavirus 2. Their risk of hospitalisation for coronavirus disease 2019 (COVID-19), and that of their households, is poorly understood. Design and settings and participants: During the peak period for COVID-19 infection in Scotland (1st March 2020 to 6th June 2020) we conducted a national record linkage study to compare the risk of COVID-19 hospitalisation among healthcare workers (age: 18-65 years), their households and other members of the general population. Main outcome: Hospitalisation with COVID-19 Results: The cohort comprised 158,445 healthcare workers, the majority being patient facing (90,733 / 158,445; 57.3%), and 229,905 household members. Of all COVID-19 hospitalisations in the working age population (18-65-year-old), 17.2% (360 / 2,097) were in healthcare workers or their households. Adjusting for age, sex, ethnicity, socio-economic deprivation and comorbidity, the risk of COVID-19 hospitalisation in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazards ratio [HR] 0.81; 95%CI 0.52-1.26 and 0.86; 95%CI 0.49-1.51 respectively). In models adjusting for the same covariates however, patient facing healthcare workers, compared to non-patient facing healthcare workers, were at higher risk (HR 3.30; 95%CI 2.13-5.13); so too were household members of patient facing healthcare workers (HR 1.79; 95%CI 1.10-2.91). On sub-dividing patient-facing healthcare workers into those who worked in front-door, intensive care and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (HR 2.09; 95%CI 1.49-2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of COVID-19 hospitalisation was less than 0.5% but was 1% and above in older men with comorbidity. Conclusions: Healthcare workers and their households contribute a sixth of hospitalised COVID-19 cases. Whilst the absolute risk of hospitalisation was low overall, patient facing healthcare workers and their households had 3- and 2-fold increased risks of COVID-19 hospitalisation.

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Incidence, Microbiology, and Outcomes in Patients Hospitalized With Infective Endocarditis

Abstract: Supplemental Digital Content is available in the text.

Cited by 109 publications

References 44 publications

Insight into the epidemiology of infective endocarditis in Portugal: a contemporary nationwide study from 2010 to 2018

Insight into the epidemiology of infective endocarditis in Portugal: a contemporary nationwide study from 2010 to 2018

Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study

Risk of hospitalisation with coronavirus disease 2019 in healthcare workers and their households: a nationwide linkage cohort study

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