Abstract 17637: The Incidence of Endocarditis in Canada is Decreasing
Background: Infectious endocarditis (IE) is a potentially preventable complication of congenital heart disease and acquired valvular disease. In 2007 the American Heart Association (AHA) published revised guidelines for IE prophylaxis. The impact of these guidelines on IE hospitalization rates, at a population-level, has not been examined. Objectives: To describe hospitalization rates of IE in Canada during the last decade and examine the impact, if any, of the 2007 AHA guidelines.
Methods: The Canadian Institute for Health Information Discharge database was used to identify all IE hospitalizations between April 1, 2001 and March 31, 2010. Time was categorized into fiscal year quarters. IE hospitalization rates were calculated using age-specific population estimates from Statistics Canada. We considered April 1, 2008 as the beginning of the post-guidelines period, allowing 12 months from guideline publication to incorporation into clinical practice. The change in IE hospitalization rates before and after guideline was examined using Poisson regression.
Results: 23 704 hospitalizations with a diagnosis of IE occurred during the study period. There was an annual 3% decrease in IE hospitalization rate over time (Figure, time trend ratio 0.974, 95% CI 0.968, 0.981, P<0.001). The interaction term between time and IE hospitalization rates before and after guideline publication was non-significant. IE hospitalization rates were highest in those age 65+, compared to 18-64 year olds and children < 18 years (20.57, 3.87 and 0.76/100 000 persons, respectively, p<0.0001).
Conclusions: The rate of IE hospitalizations decreased over time in Canada from 2001-2010. We observed no significant change in this trend relative to the revised AHA guidelines published in 2007. Continued surveillance is required to confirm that more restrictive recommendations for prophylaxis will not result in an increase in IE rates.
- Congenital heart disease
- Valvular heart disease
- Adult congenital heart disease
- © 2012 by American Heart Association, Inc.