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Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000–2012)
Ist Teil von
Infectious diseases and therapy, 2023-04, Vol.12 (4), p.1083-1101
Ort / Verlag
Cheshire: Springer Healthcare
Erscheinungsjahr
2023
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
Introduction
Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide.
Methods
The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century.
Results
IE cases from 13 European countries were included. Two periods were considered: 2000–2006 and 2008–2012. Two European regions were considered, according to the United Nations geoscheme for Europe: Southern (SE) and Northern–Central Europe (NCE). Comparisons were performed between regions and periods. A total of 4195 episodes of IE were included, 2113 from SE and 2082 from NCE; 2787 cases were included between 2000 and 2006 and 1408 between 2008 and 2012. Median (IQR) age was 63.7 (49–74) years and 69.4% were males. Native valve IE (NVE), prosthetic valve IE (PVE), and device-related IE were diagnosed in 68.3%, 23.9%, and 7.8% of cases, respectively; 52% underwent surgery and 19.3% died during hospitalization. NVE was more prevalent in NCE, whereas device-related IE was more frequent in SE. Higher age, acute presentation, hemodialysis, cancer, and diabetes mellitus all were more prevalent in the second period. NVE decreased and PVE and device-related IE both increased in the second period. Surgical treatment also increased from 48.7% to 58.4% (
p
< 0.01). In-hospital and 6-month mortality rates were comparable between regions and significantly decreased in the second period.
Conclusions
Despite an increased complexity of IE cases, prognosis improved in recent years with a significant decrease in 6-month mortality. Outcome did not differ according to the European region (SE versus NCE).
Graphical Abstract