Cor Vasa 2016, 58(6):e576-e583 | DOI: 10.1016/j.crvasa.2015.10.008

Changing profile of infective endocarditis in patients hospitalised in a tertiary Czech hospital from 2000 to 2013

Jana Bínová^a, Miloš Kubánek^a,*, Eva Koudelková^a, Jana Vrbská^a, Jiří Kettner^b, Petr Kačer^c, Tomáš Kotulák^d, Dana Němcová^a, Josef Kautzner^a, Jan Pirk^b

^a Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

^b Klinika kardiochirurgie, Institut klinické a experimentální medicíny, Praha, Česká republika

^c Klinika anestezie a resuscitace, Institut klinické a experimentální medicíny, Praha, Česká republika

^d Oddělení klinické mikrobiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

Introduction: Despite advances in diagnostics and treatment of infective endocarditis (IE), the high morbidity and mortality of this disease remains a substantial problem for health-care systems. Our aim was to describe the spectrum of IE in individuals hospitalised in a tertiary Czech hospital. In addition, we decided to identify risk factors for the mortality and recurrence of IE.

Materials and methods: We performed a retrospective analysis in 334 patients diagnosed with definite IE according to modified Duke Criteria. The patients were hospitalised in the cardiac centre at IKEM during the years 2000-2013. This time period was divided into two seven-year intervals and patient characteristics were compared between these periods. Predictors of mortality and recurrence of IE were identified using Cox regression analysis within a median follow-up of 36 months (4-77 months).

Results: The study group included 186 patients (56%) with native valve IE, 81 patients (24%) with prosthetic valve IE and 67 patients (20%) with device-related IE. Comparison of the time periods 2000-2006 and 2007-2013 revealed an increase in the number of patients with IE of 78%. Furthermore, the percentage of individuals with native valve IE decreased, which was accompanied by a marked increase in the proportion of prosthetic valve and device-related IE. Despite the increasing age of patients, the rising prevalence of diabetes and growing body weight (measured by body mass index), we observed a similar survival rate in both time periods for each type of IE. Recurrence of IE was observed in just 3% of patients during follow-up, but more frequently in intravenous drug addicts.

Conclusion: Changing epidemiology of IE with increasing incidence of prosthetic valve and device-related IE was obvious also in our hospital. Although the risk profile of patients worsened, we observed a similar survival rate in both time periods for each type of IE.

Keywords: Epidemiology; Infective endocarditis; Prognosis; Treatment

Received: September 11, 2015; Revised: September 22, 2015; Accepted: October 24, 2015; Published: December 1, 2016  Show citation