Twenty-Year Secular Trends in Infective Endocarditis in a Teaching Hospital
Por:
Cuervo G, Rombauts A, Caballero Q, Grau I, Pujol M, Ardanuy C, Berbel D, Gudiol C, Sánchez-Salado JC, Ruiz-Majoral A, Sbraga F, Gracia-Sánchez L, Peña C and Carratalà J
Publicada:
1 ago 2018
Ahead of Print:
27 jul 2018
Resumen:
Background. The purpose of this study was to analyze the secular trends of infective endocarditis in a teaching hospital between January 1996 and December 2015.
Methods. We report on a single-center retrospective study of patients with left-side valve infective endocarditis. We performed an analysis of secular trends in the main epidemiological and etiological aspects, as well as clinical outcomes, in 5 successive 4-year periods (P1 to P5).
Results. In total, 595 episodes of infective endocarditis were included, of which 76% were community-acquired and 31.3% involved prosthetic valves. Among the cases, 70% occurred in men, and the mean age (SD) was 64.1 (14.3) years. A significant increase in older patients (age >= 70 years) between P1 (15.332%) and P5 (51.9%; P<.001) was observed. The rate of infective endocarditis on biological prostheses also increased in the prosthetic group, accounting for 30% in P1 and 67.3% in P5 (P<.001). By contrast, there were significant decreases in vascular and immunological phenomena over the study period, with decreases in the presence of moderate to severe valvular insufficiency (75.9% in P1 to 52.6% in P.5; P<.001) and valvular surgery (43% in P1 vs 29.6% in P.5; P=.006). Finally, overall mortality was 23.9%, and although it was highest in P1, it subsequently remained stable through P2 to P5 (38% in P1 to 20% in P5; P=.004).
Conclusions. There has been a significant increase in infective endocarditis in older patients. The decrease in moderate to severe valve regurgitation at diagnosis could explain the stable mortality despite the increase in the mean age of patients over time.
Filiaciones:
Cuervo G:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Rombauts A:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Caballero Q:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Grau I:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
Pujol M:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Ardanuy C:
Department of Microbiology, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
Berbel D:
Department of Microbiology, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
Gudiol C:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Sánchez-Salado JC:
Department of Cardiology, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Ruiz-Majoral A:
Department of Cardiology, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Sbraga F:
Department of Cardiac Surgery, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
Gracia-Sánchez L:
Department of Nuclear Medicine, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
:
Department of Infectious Diseases, Hospital Virgen de los Lirios de Alcoy, Alicante, Spain
Carratalà J:
Department of Infectious Diseases, Hospital Universitari de Bellvitge, IDIBELL (Institut d'Investigació Biomèdica de Bellvitge), University of Barcelona, Barcelona, Spain
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