Abstract 20605: Population Trends in the Incidence, Etiology and Outcomes of Infective Endocarditis
Background: Data regarding the epidemiology of infective endocarditis in the United States are insufficient to allow effective evaluation of healthcare promotion efforts.
Study aim: The aim of this study was to quantify trends in etiology, incidence and outcomes of infective endocarditis.
Methods: Patients hospitalized with endocarditis between 1997 and 2013 in New York State were identified from a mandatory state database. Crude incidence was adjusted for age, sex and race to give standardized incidence, and trends were assessed by multivariable Poisson regression analysis. Trends in risk factors including health care exposure up to 90 days prior to diagnosis, organism and location were analyzed; 90-day outcomes were determined from state administrative and national Social Security Death Index.
Results: A total of 31,740 patients with endocarditis were identified. Although crude incidence of endocarditis increased between 1997 and 2013 from 8.7 to 10.8/100,000 per capita (p<0.001), standardized incidence was stable (p=0.27) (Figure 1). The proportion of patients with native valve endocarditis decreased from 77.3% to 67.4% (p<0.001); while endocarditis related to prosthetic valves, pacemakers and defibrillators, and intravenous drug use increased (12.6% to 16.2%, 1.1% to 4.9%, and 8.9% to 11.5% respectively) (all p<0.001). The proportion of patients with Staphylococcus aureus rose from 26.5% to 34.0% (p<0.001), and methicillin resistant Staphylococcus aureus increased from 2.0% to 14.1% (p<0.001). The proportion of patients with viridans group streptococci did not increase (10.5% to 9.5% p=0.42). The unadjusted 90-day mortality of endocarditis ranged from 23.5% in 1997 to a peak of 31.4% in 2001.
Conclusions: In New York State the standardized incidence of endocarditis did not change significantly between 1997 and 2013. However, changes in the etiology of endocarditis may indicate targets for more effective prophylaxis and therapeutic strategies.
Author Disclosures: N. Toyoda: None. J. Chikwe: None. S. Itagaki: None. A. Anyanwu: None. D.H. Adams: Other; Significant; Edwards Lifesciences, Medtronic. N.N. Egorova: None.
- © 2016 by American Heart Association, Inc.