Epidemiology and global burden of infective endocarditis

ESC CardioMed ◽  
2018 ◽  
pp. 325-328 ◽  
Author(s):  
Imad M. Tleyjeh ◽  
Aref A. Bin Abdulhak
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Case Fatality ◽  
Cardiac Transplant ◽  
The World ◽  
Emerging Risk ◽  
Significant Burden ◽  
Traditional Risk Factors ◽  
Case Fatality Risk

Infective endocarditis (IE) is still considered to be an infrequent but fatal and debilitating disease if left untreated. It is estimated that IE affects 3–7.5 people per 100,000 person-years and its incidence is reported to be increasing in some parts of the world. IE incidence appears to vary significantly as reported from different geographic areas even within the same country. IE is a disabling and lethal disease with an overall mean proportion of IE-related stroke of 15.8% ± 9.1%, a mean proportion of patients that have undergone valve surgery of 32.4% ± 18.8%, and a mean case fatality risk of 21.1% ± 10.4%. IE incidence remains largely unknown from many parts of the world due to a paucity of data from several countries. Intravenous drug use, advanced age, intracardiac electronic devices, degenerative valvular heart disease, cardiac transplant with development of valvulopathy, haemodialysis, HIV infection, and diabetes mellitus are among the new emerging risk factors that have recently been shown to be implicated more frequently than the traditional risk factors in IE development. Staphylococcus aureus is the leading cause of IE worldwide and has taken predominance over viridans group streptococci in many parts of the world. Globally, IE is associated with a significant burden and was responsible for 45,000 deaths in 1990 and 65,000 deaths in 2013. The mortality rate from IE is significantly high, with an in-hospital mortality rate of up to 22% and a 5-year mortality rate of 45%.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

The Comparison of Susceptibility to SARS-CoV-2 Infection between Pediatric and Adults

2021 ◽  
Author(s):  
Milad Zandi ◽  
Saber Soltani ◽  
Mona Fani ◽  
Haniye Shafipour ◽  
Samaneh Abbasi
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Mortality Rate ◽  
Age Groups ◽  
Severe Illness ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
The World ◽  
Smoking Susceptibility ◽  
The Relationship

SARS-CoV-2 causes coronavirus disease 2019 (COVID-19) and is responsible for the recent pandemic in the world. It has been recently recognized as a challenge for public health and a significant cause of severe illness in all age groups. Young children and older people are susceptible to SARS-CoV-2 infection. However, children usually present mild symptoms compared to adult patients. The relationship between age, severity, and COVID-19 transmission is compared to determine whether there is any reasonable relationship between age and COVID-19. It should be mentioned that some risk factors may increase the probability of developing severe COVID-19 by advancing age, such as pathophysiological changes in the respiratory system, angiotensin-converting enzyme 2 expression in the nasopharynx, and smoking. Susceptibility to SARS-CoV-2 infection is independent of age, but the mortality rate of COVID-19 depends on age.

scholarly journals Epidemiology of Coronavirus disease 2019 (COVID-19)

2020 ◽  
Vol 1 (2) ◽  
pp. 14-20
Author(s):  
T. N. Bilichenko
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Statistical Data ◽  
Preventive Measures ◽  
Clinical Manifestations ◽  
Research Information ◽  
The World ◽  
Main Factors ◽  
Course Outcomes ◽  
Official Sources

An analysis of epidemiology coronavirus disease 2019 (COVID-19) in Russia and the world was carried out to identify the main factors contributing to morbidity and mortality due to COVID-19, pathogenesis and clinical manifestations of the disease. Statistical data were used from official sources (Rospotrebnadzor, WHO, US CDC, China NHC, ECDC, DXY). Research information from different countries about the course, outcomes, spread, and risk factors of the disease is presented.The study of epidemiology, risk factors, causes of increased incidence of COVID-19, mortality rate is of great importance for assessing the effectiveness of preventive measures.

scholarly journals Risk factors for incidence and case-fatality rates of healthcare-associated infections: a 20-year follow-up of a hospital-based cohort

2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Fatality ◽  
Healthcare Associated Infections ◽  
Fatality Rate ◽  
Infection Site ◽  
Healthcare Associated

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

scholarly journals Case Fatality Risk of the First Pandemic Wave of Coronavirus Disease 2019 (COVID-19) in China

2020 ◽  
Author(s):  
Xiaowei Deng ◽  
Juan Yang ◽  
Wei Wang ◽  
Xiling Wang ◽  
Jiaxin Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influenza Pandemic ◽  
Mainland China ◽  
Case Fatality ◽  
Likelihood Estimation ◽  
H1n1 Influenza ◽  
Right Censoring ◽  
Time To Event ◽  
Fatality Risk ◽  
Case Fatality Risk

Abstract Background To assess the case fatality risk (CFR) of COVID-19 in mainland China, stratified by region and clinical category, and estimate key time-to-event intervals. Methods We collected individual information and aggregated data on COVID-19 cases from publicly available official sources from 29 December 2019 to 17 April 2020. We accounted for right-censoring to estimate the CFR and explored the risk factors for mortality. We fitted Weibull, gamma, and log-normal distributions to time-to-event data using maximum-likelihood estimation. Results We analyzed 82 719 laboratory-confirmed cases reported in mainland China, including 4632 deaths and 77 029 discharges. The estimated CFR was 5.65% (95% confidence interval [CI], 5.50–5.81%) nationally, with the highest estimate in Wuhan (7.71%) and lowest in provinces outside Hubei (0.86%). The fatality risk among critical patients was 3.6 times that of all patients and 0.8–10.3-fold higher than that of mild-to-severe patients. Older age (odds ratio [OR], 1.14 per year; 95% CI, 1.11–1.16) and being male (OR, 1.83; 95% CI, 1.10–3.04) were risk factors for mortality. The times from symptom onset to first healthcare consultation, to laboratory confirmation, and to hospitalization were consistently longer for deceased patients than for those who recovered. Conclusions Our CFR estimates based on laboratory-confirmed cases ascertained in mainland China suggest that COVID-19 is more severe than the 2009 H1N1 influenza pandemic in hospitalized patients, particularly in Wuhan. Our study provides a comprehensive picture of the severity of the first wave of the pandemic in China. Our estimates can help inform models and the global response to COVID-19.

scholarly journals Infective endocarditis at a tertiary care hospital in South Korea

Heart ◽  
2020 ◽  
Vol 107 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Nam Su Ku ◽  
Seung Hyun Lee ◽  
Sak Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Care Hospital ◽  
Multivariable Logistic Regression ◽  
Long Term Prognosis

ObjectiveThe treatment of infective endocarditis (IE) has become more complex with the current myriad healthcare-associated factors and the regional differences in causative organisms. We aimed to investigate the overall trends, microbiological features, and outcomes of IE in South Korea.MethodsA 12-year retrospective cohort study was performed. Poisson regression was used to estimate the time trends of IE incidence and mortality rate. Risk factors for in-hospital mortality were identified with multivariable logistic regression, and model comparison was performed to evaluate the predictive performance of notable risk factors. Kaplan-Meier survival analysis and Cox regression were performed to assess long-term prognosis.ResultsWe included 419 patients with IE, the incidence of which showed an increasing trend (relative risk 1.06, p=0.005), whereas mortality demonstrated a decreasing trend (incidence rate ratio 0.93, p=0.020). The in-hospital mortality rate was 14.6%. On multivariable logistic regression analysis, aortic valve endocarditis (OR 3.18, p=0.001), IE caused by Staphylococcus aureus (OR 2.32, p=0.026), neurological complications (OR 1.98, p=0.031), high Sequential Organ Failure Assessment score (OR 1.22, p=0.023) and high Charlson Comorbidity Index (OR 1.11, p=0.019) were predictors of in-hospital mortality. Surgical intervention for IE was a protective factor against in-hospital mortality (OR 0.25, p<0.001) and was associated with improved long-term prognosis compared with medical treatment only (p<0.001).ConclusionsThe incidence of IE is increasing in South Korea. Although the mortality rate has slightly decreased, it remains high. Surgery has a protective effect with respect to both in-hospital mortality and long-term prognosis in patients with IE.

scholarly journals 146. Infective Endocarditis in South Korea: a 12-year Single-Center Experience of 419 Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S100-S101
Author(s):  
Jung Ho Kim ◽  
Hi Jae Lee ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Jin young Ahn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
South Korea ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Logistic Regression Analysis

Abstract Background Infective endocarditis (IE) is a potentially lethal disease that has undergone constant changes in epidemiology and pathogen. Treatment of IE has become more complex with today’s myriad healthcare-associated factors as well as regional differences in causative organisms. Therefore, it is necessary to investigate the overall trends, microbiological features, clinical characteristics and outcomes of IE in South Korea. Methods We performed a retrospective cohort study of patients with the diagnosis of probable or definite IE according to the modified Duke Criteria admitted to a tertiary care center in South Korea between November 2005 and August 2017. Poisson log-linear regression was used to estimate time trends of IE incidence rate and mortality rate. Risk factors for in-hospital mortality were evaluated by multivariate logistic regression analysis including an interaction term. Results There were 419 IE patients (275 male vs. 144 female) during the study period. The median age of the patients was 56 years. The annual incidence rate of IE of our institution was significantly increased. (RR 1.05; 95% CI, 1.02–1.08; P = 0.006) The mortality rate showed trends toward down, but not statistically significant (P = 0.875). IE was related to a prosthetic valve in 15.0% and 21.7% patients developed IE during hospitalization. The mitral valve was the most commonly affected valve (61.3%). Causative microorganisms were identified in 309 patients (73.7%) and included streptococci (34.6%), followed by Staphylococcus aureus (15.8%) and enterococci (7.9%). The in-hospital mortality rate was 14.6%. Logistic regression analysis found aortic valve endocarditis (OR 3.18; P = 0.001), IE caused by staphylococcus aureus (OR 2.32; P = 0.026), a presence of central nervous system embolic complication (OR 1.98; P = 0.031), a high SOFA score (OR 1.22; P = 0.023) and a high Charlson’s comorbidity index (OR 1.11; P = 0.019) as predictors of in-hospital mortality. On the other hand, surgical intervention for IE was found to be a protective factor against mortality. (OR 0.25, P < 0.001) Conclusion Although IE has been increasing, the mortality rate has not yet reduced significantly. Studies on causative organisms of IE and risk factors for mortality are warranted in improving prognosis. Disclosures All authors: No reported disclosures.

ID: 99: PREVELNACE, MORBIDTY AND MORTALITY OF INFECTIVE ENDOCARDITIS IN THE MOST DIVESE AREA OF USA IN NEW YORK CITY

2016 ◽  
Vol 64 (4) ◽  
pp. 952.2-952
Author(s):  
H Alkhawam ◽  
R Sogomonian ◽  
F Zaiem ◽  
N Vyas ◽  
J Jolly ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Readmission Rate ◽  
Heart Valves ◽  
Age Groups ◽  
Morbidity And Mortality ◽  
Causative Organism ◽  
Group D

BackgroundInfective endocarditis (IE) is a serious illness associated with significant morbidity and mortality. The primary purpose of this study was to evaluate the mortality and morbidity of IE in a community public hospital of the most diverse area in New York.MethodsAn analysis of 209 patients that were admitted to hospital from 2000 to 2012, found to have IE based on Duke's criteria.ResultsThe incidence rate of IE is trending down since 2000 (figure 1A).Among our study population, the overall mortality rate of IE was 20.1% (95% CI: 9.84–19.56%), readmission rate within 30 days after discharge was 21.5% (95% CI: 16.22–27.58%) with an average age of 59 years (95% CI: 57.63–60.37%). The most common causative organisms were staphylococcus aureus (43.7%), followed by streptococcus viridians (17%) and Group D enterococcus (14.7%). We divided the patients into two groups; male (n=107) versus female (n=102). And the same aspects were identified and studied in each gender group.The incidence of IE has a slight female predominance, except two age groups with male significant predominance; 40–49 and 50–59 years. (figure 1-B).The mortality rate in males was 17% vs 23% in females (p=0.09) and Readmission rate within 30 days after discharge from the hospital was 20% in males vs 22% in females (p=0.1).Of the 209 patients, 188 patients were with native hearts and 21 patients had non-native heart valves. Of the 188 native heart valves, 114 had risk factors such as: CABG surgeries, were active drugs users, had pacemakers, valves disease or CHF. Mortality rate in non-native hearts and/or patients with risk factors were 27.7% compared to patients with native heart without risk factors of 8.11%(OR:3, P<0.0001).The causative organism of IE was evaluated in our study and we found that S. aureus is the most common cause in males and females among all age groups. The only exception to that is a slightly higher prevalence of S. viridians in males between the ages of 30–39 (figure1-C). Similarly, the prevalence of group D enterococcus appeared higher in females aged 70–79 years. (figure 1-D).Approximately 71% of males' patient with S. aureus IE between ages 50–49 had DM. Also, 80% of female patients with IE between ages 60–69 had DM which could explain the high prevalence of IE with S. aureus in this age groups as DM may complicated with skin infections which is mostly Staphylococcus infection that led to IE.The highest incidences of IE in our study were in Hispanic ethnicity group (38%) follow by white (29%). However, the lowest incidences were observed in South Asia population (5%).ConclusionDespite appropriate prophylaxis and treatment of IE patients, high rates of incidences, morbidity and mortality remained especially in population >50 years. Risk factors for developing IE such as Diabetes Mellitus which might complicated with skin infection and lead to IE, raising the importance of controlling and monitoring risk factors for IE in patients older than 50 years of age.Abstract ID: 99 Figure 1

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