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. 2025 Aug 11;40(31):e183.
doi: 10.3346/jkms.2025.40.e183.

Trends in Epidemiology, Clinical Characteristics, and Outcomes of Infective Endocarditis: A 16-Year Nationwide Cohort Study in Korea

Kyung Eun Ha  1 , William D Kim  2 , Kyu-Yong Ko  3 , Hasung Kim  4 , Seo-Yeon Gwak  5 , Kyu Kim  5 , Hyun-Jung Lee  5 , Chi Young Shim  5 , Geu-Ru Hong  5 , Jong-Won Ha  5 , Ji-Won Hwang  6 , Iksung Cho  7
Affiliations

Trends in Epidemiology, Clinical Characteristics, and Outcomes of Infective Endocarditis: A 16-Year Nationwide Cohort Study in Korea

Kyung Eun Ha et al. J Korean Med Sci. .

Abstract

Background: Infective endocarditis (IE) is a life-threatening disease, the profile of which varies across countries. This nationwide cohort study aimed to assess the epidemiology, clinical characteristics, and outcomes of IE.

Methods: Patients diagnosed with IE between 2003 and 2018 were included in this study based on data from the National Health Insurance System of South Korea. The patients' baseline characteristics, treatment modalities, and survival outcomes were analyzed. The incidence and in-hospital mortality rates were calculated and adjusted for age.

Results: A total of 8,487 IE cases were included: 6,617 (78.0%), 1,678 (19.8%), and 192 (2.3%) cases of native valve IE, prosthetic valve IE, and cardiac device-related IE (CDRIE), respectively. The incidence rate (per 1,000,000) of IE increased from 7.24 in 2003 to 17.47 in 2018. Furthermore, the in-hospital mortality rate for IE (per 1,000,000 person-years) increased from 0.59 in 2003 to 2.76 in 2018. The proportions of prosthetic valve IE and CDRIE cases increased over time, whereas that of native valve IE cases decreased. The number of surgeries for IE showed a consistent upward trend, with a notable increase occurring from 2014 onward.

Conclusion: IE is a health burden with an increasing incidence and high mortality rates. Understanding the epidemiology and characteristics of IE is crucial to establish future treatment strategies.

Keywords: Cohort Study; Epidemiology; Infective Endocarditis; Korea.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flowchart of this study.
NHIS = National Health Insurance Service, IE = infective endocarditis, NVE = native valve endocarditis, PVE = prosthetic valve endocarditis, CDRIE = cardiac device-related infective endocarditis.
Fig. 2
Fig. 2. Temporal trends in the incidence of infective endocarditis in South Korea from 2003 to 2018.
Fig. 3
Fig. 3. Temporal trends in the incidence of infective endocarditis by valve type subgroups from 2003 to 2018.
NVE = native valve endocarditis, PVE = prosthetic valve endocarditis, CDRIE = cardiac device-related infective endocarditis.
Fig. 4
Fig. 4. Temporal trends in infective endocarditis from 2003 to 2018, illustrating (A) annual changes in in-hospital mortality rates and (B) annual trends in surgical treatment frequencies.
NVE = native valve endocarditis, PVE = prosthetic valve endocarditis, CDRIE = cardiac device-related infective endocarditis.
See this image and copyright information in PMC

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