Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016

Abstract

Background: To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years. Methods: A retrospective cohort study was performed. A total of 407 consecutive patients who were admitted with infective endocarditis were included. The clinical characteristics and the risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ± 16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 11.3%. Among patients with underlying heart disease, congenital heart disease was the most common (25.8%), followed by rheumatic heart disease (17.0%) which showed a decreased trend during this period (P < 0.001). There were 222(54.5%) patients with positive blood cultures results and Streptococci (24.6%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 235 patients (57.7%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P < 0.001, OR = 28.594, 95% CI 5.561-148.173) and vegetation length>30 mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality. Conclusions: There were no significant changes in the overall incidence of infective endocarditis, but the clinical features of infective endocarditis had slightly changed during the past ten years. Streptococci infective endocarditis was still the predominant. Patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length>30 mm had an worse in-hospital outcome.

Frequency, Mortality, and Predictors of Adverse Outcomes for Endocarditis in Patients with Congenital Heart Disease: Results of a Nationwide Analysis including 2512 Endocarditis Cases

“…Consistent with previous studies we found that CHD was a common factor associated with IE in children, being present in 36% of paediatric IE cases [ 2 , 20 , 21 , 22 , 23 ]. In contrast, CHD related IE made up only 1.2% of all adult IE cases.…”

Temporal trends and patterns of infective endocarditis in a Chinese population: A territory-wide study in Hong Kong (2002–2019)

“… 2 In Hong Kong, the incidence of IE remained stable in the past two decades, which is in line with studies from other regions and previous Asian studies carried out in China. 4 , 6 , 10 , 24 , 25 For example, a previous North American study reported a stable trend incidence of 7.8 per 100,000 person-year in 2013. 6 A recent Scottish study also identified a static incidence with a rate of 8.1 per 100,000 person-year in 2014.…”

“… 1 , 4 , 5 , 6 Previous studies performed in Asia were either from a single centre or did not comprehensively assess changes in incidence, demographics, and outcomes. 8 , 9 , 10 , 11 , 12 The temporal changes in incidence, patient characteristics, and related mortality of IE, remain unknown in the Asian population.…”

Catastrophic Candida prosthetic valve endocarditis and COVID-19 comorbidity: A rare case

“…Endocarditis is a severe infectious disease with a high mortality rate [ 2 - 5 ]. Its in-hospital mortality rates are 12-17%, 23%-26%, 10%, and 8% for inherent valve, prosthetic valve, cardiac implantable electronic device, and right-sided endocarditis, respectively [ 6 ]. Fungal endocarditis in patients with prostatic valves can be a severe threat with high mortality and morbidity [ 7 ].…”