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. 2023 Dec 12;8(12):516.
doi: 10.3390/tropicalmed8120516.

Trends of Infective Endocarditis at Two Teaching Hospitals: A 12-Year Retrospective Cohort Study in Rio de Janeiro, Brazil

Paulo Vieira Damasco  1   2 , Victor Edgar Fiestas Solórzano  3 , Natália Rodrigues Querido Fortes  4 , Daniel Xavier de Brito Setta  2 , Aloysio Guimaraes da Fonseca  2 , Mario Castro Alvarez Perez  2 , João Carlos Jazbick  2 , Jonathan Gonçalves-Oliveira  5 , Marco Aurélio Pereira Horta  5 , Elba Regina Sampaio de Lemos  5 , Claudio Querido Fortes  4
Affiliations

Trends of Infective Endocarditis at Two Teaching Hospitals: A 12-Year Retrospective Cohort Study in Rio de Janeiro, Brazil

Paulo Vieira Damasco et al. Trop Med Infect Dis. .

Abstract

Background: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce.

Methods: This retrospective cohort study included 240 patients diagnosed with IE according to the modified Duke criteria who were admitted to two university hospitals in Rio de Janeiro, Brazil from January 2009 to June 2021. Poisson regression analysis was performed for trend tests. The multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) of predictors of in-hospital mortality.

Findings: The median age was 55 years (IQR: 39-66 years), 57% were male, and 41% had a Charlson comorbidity index (CCI) score > 3. Healthcare-associated infective endocarditis (54%), left-sided native valve IE (77.5%), and staphylococcal IE (26%) predominated. Overall, in-hospital mortality was 45.8%, and mortality was significantly higher in the following patients: aged ≥ 60 years (53%), CCI score ≥ 3 (60%), healthcare-associated infective endocarditis (HAIE) (53%), left-sided IE (51%), and enterococcal IE (67%). Poisson regression analysis showed no trend in in-hospital mortality per year. The adjusted multivariate model determined that age ≥ 60 years was an independent risk factor for in-hospital mortality (HR = 1.9; 95% CI 1.2-3.1; p = 0.008).

Interpretation: In this 12-year retrospective cohort, there was no evidence of an improvement in survival in patients with IE. Since older age is a risk factor for mortality, consensus is needed for the management of IE in this group of patients.

Keywords: Brazil; endocarditis; mortality; retrospective cohort.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of infective endocarditis cases by year and outcome.
Figure 2
Figure 2
Patients aged ≥ 60 years had higher in-hospital mortality (HR = 1.9; 95% CI 1.2–3.1; p = 0.008).
See this image and copyright information in PMC

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