Incidence, characteristics, and mortality of infective endocarditis in France in 2011

Abstract

ObjectivesWe assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011.MethodsIE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality.ResultsThe analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE.ConclusionWe reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality.

Risk factors and outcomes of early acute kidney injury in infective endocarditis: A retrospective cohort study

“…Twenty-seven per cent of patients underwent heart valve surgery. This was consistent with recent data on French epidemiology and a recent prospective study in older patients (mean age 83 years) showing that surgery was performed in 16% of cases (Sunder et al, 2019;Forestier et al, 2019).…”

Characteristics, management, and outcome of infective endocarditis in the Czech Republic: prospective data from the ESC EORP EURO-ENDO registry

“…The recent study in Spain demonstrated an increasing incidence of IE in pacemakers (22). CDRIE represented 27.4 % of all IE cases in our cohort, which is a substantially higher number compared to other reports from the European countries, including the overall results of EURO-ENDO registry (1,23,24). We may speculate, whether such high proportion of patients with CDRIE might have been affected by involvement of only tertiary care centres in our cohort, which 82 % (9/11) out of them possess Cardiac surgery department performing the most complicated cases, including lead extractions.…”

High Mortality and Graft Loss After Infective Endocarditis in Kidney Transplant Recipients: A Case-Controlled Study From Two Centers

“…IE is well described in the general population [1,6,7]. There are also numerous reports in hemodialysis (HD) patients, where IE is reported as both frequent and deadly, with a 45.6% mortality [8][9].…”