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. 2023 Apr;12(4):1083-1101.
doi: 10.1007/s40121-023-00763-8. Epub 2023 Mar 15.

Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000-2012)

Juan Ambrosioni #  1   2 , Marta Hernández-Meneses #  3 , Emanuele Durante-Mangoni  4 , Pierre Tattevin  5 , Lars Olaison  6 , Tomas Freiberger  7   8 , John Hurley  9 , Margaret M Hannan  9 , Vivian Chu  10 , Bruno Hoen  11 , Asunción Moreno  3 , Guillermo Cuervo  3 , Jaume Llopis #  12 , José M Miró #  13   14 ; International Collaboration for Endocarditis (ICE) Investigators
Collaborators, Affiliations

Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000-2012)

Juan Ambrosioni et al. Infect Dis Ther. 2023 Apr.

Erratum in

Abstract

Introduction: Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide.

Methods: The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century.

Results: IE cases from 13 European countries were included. Two periods were considered: 2000-2006 and 2008-2012. Two European regions were considered, according to the United Nations geoscheme for Europe: Southern (SE) and Northern-Central Europe (NCE). Comparisons were performed between regions and periods. A total of 4195 episodes of IE were included, 2113 from SE and 2082 from NCE; 2787 cases were included between 2000 and 2006 and 1408 between 2008 and 2012. Median (IQR) age was 63.7 (49-74) years and 69.4% were males. Native valve IE (NVE), prosthetic valve IE (PVE), and device-related IE were diagnosed in 68.3%, 23.9%, and 7.8% of cases, respectively; 52% underwent surgery and 19.3% died during hospitalization. NVE was more prevalent in NCE, whereas device-related IE was more frequent in SE. Higher age, acute presentation, hemodialysis, cancer, and diabetes mellitus all were more prevalent in the second period. NVE decreased and PVE and device-related IE both increased in the second period. Surgical treatment also increased from 48.7% to 58.4% (p < 0.01). In-hospital and 6-month mortality rates were comparable between regions and significantly decreased in the second period.

Conclusions: Despite an increased complexity of IE cases, prognosis improved in recent years with a significant decrease in 6-month mortality. Outcome did not differ according to the European region (SE versus NCE).

Keywords: Cardiac surgery; Epidemiology; Europe; Infective endocarditis; Mortality.

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Conflict of interest statement

José M. Miró received a personal 80:20 research grant from the Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, during 2017–23. Margaret M. Hannan held a Rio Hortega Research Grant (CM17/00062) from the “Instituto de Salud Carlos III” and the “Ministerio de Economia y Competitividad”, Madrid (Spain) in 2018-20. Juan Ambrosioni, Marta Hernández-Meneses, Emanuele Durante-Mangoni, Pierre Tattevin, Lars Olaison, Tomas Freiberger, John Hurley, Vivian Chu, Bruno Hoen, Asunción Moreno, Guillermo Cuervo and Jaume Llopis have nothing to declare.

Figures

Fig. 1
Fig. 1
Countries, centers, and cases from ICE cohort included in the study. Green: Northern–Central European countries included in the study. Red: Southern European countries included in the study
Fig. 2
Fig. 2
Flow chart of cases included in the study. NCE Northern and Central European countries (according to the UN geoscheme), SE Southern European countries (according to the UN geoscheme)
Fig. 3
Fig. 3
Kaplan–Meir curves of 6-month mortality for 4195 IE cases included in the study, according to pre-established regions and periods. SE Southern-European Countries; NCE Northern–Central European Countries
Fig. 4
Fig. 4
Analysis of mortality rate according to Charlson score, stratified by period (2000–2006 and 2008–2012)
See this image and copyright information in PMC

References

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