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


Autoři: S. Sunder aff001;  L. Grammatico-Guillon aff002;  A. Lemaignen aff004;  M. Lacasse aff004;  C. Gaborit aff003;  D. Boutoille aff005;  P. Tattevin aff006;  E. Denes aff007;  T. Guimard aff008;  M. Dupont aff009;  L. Fauchier aff010;  L. Bernard aff002
Působiště autorů: CH de Niort, Service des Maladies Infectieuses et Tropicale, Niort, France aff001;  CHRU de Tours, Unité d’Épidémiologie des données cliniques, EpiDcliC, Tours, France aff002;  Unité Inserm 1259, Université de tours, Tours, France aff003;  CHRU de Tours, Service de Médecine Interne et Maladies Infectieuses, Tours, France aff004;  CHU de Nantes, Service des Maladies Infectieuses et Tropicales, Nantes, France aff005;  CHU de Rennes, Service des Maladies Infectieuses et Réanimation Médicale, Rennes, France aff006;  CHU de Limoges, Service des Maladies Infectieuses et Tropicales, Limoges, France aff007;  CH de La Roche sur Yon, Service des Maladies Infectieuses, La Roche sur Yon, France aff008;  CH de Saint Malo, Service des Maladies Respiratoires et Infectieuses, Saint Malo, France aff009;  Equipe d’accueil EA 1275, Université de Tours, Tours, France aff010;  CHRU de Tours, Service de cardiologie, Tours, France aff011
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223857

Souhrn

Objectives

We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011.

Methods

IE 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.

Results

The 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.

Conclusion

We 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.

Klíčová slova:

Cardiac surgery – Epidemiology – France – Hospitals – Ischemic stroke – Staphylococcus aureus – Streptococcus – Surgical and invasive medical procedures


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 10