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Incidence, characteristics, and mortality of infective endocarditis in France in 2011
OBJECTIVES: We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011. METHODS: IE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed accord...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814232/ https://www.ncbi.nlm.nih.gov/pubmed/31652280 http://dx.doi.org/10.1371/journal.pone.0223857 |
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author | Sunder, S. Grammatico-Guillon, L. Lemaignen, A. Lacasse, M. Gaborit, C. Boutoille, D. Tattevin, P. Denes, E. Guimard, T. Dupont, M. Fauchier, L. Bernard, L. |
author_facet | Sunder, S. Grammatico-Guillon, L. Lemaignen, A. Lacasse, M. Gaborit, C. Boutoille, D. Tattevin, P. Denes, E. Guimard, T. Dupont, M. Fauchier, L. Bernard, L. |
author_sort | Sunder, S. |
collection | PubMed |
description | OBJECTIVES: We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011. METHODS: IE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality. RESULTS: The analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE. CONCLUSION: We reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality. |
format | Online Article Text |
id | pubmed-6814232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-68142322019-11-03 Incidence, characteristics, and mortality of infective endocarditis in France in 2011 Sunder, S. Grammatico-Guillon, L. Lemaignen, A. Lacasse, M. Gaborit, C. Boutoille, D. Tattevin, P. Denes, E. Guimard, T. Dupont, M. Fauchier, L. Bernard, L. PLoS One Research Article OBJECTIVES: We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011. METHODS: IE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality. RESULTS: The analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE. CONCLUSION: We reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality. Public Library of Science 2019-10-25 /pmc/articles/PMC6814232/ /pubmed/31652280 http://dx.doi.org/10.1371/journal.pone.0223857 Text en © 2019 Sunder et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Sunder, S. Grammatico-Guillon, L. Lemaignen, A. Lacasse, M. Gaborit, C. Boutoille, D. Tattevin, P. Denes, E. Guimard, T. Dupont, M. Fauchier, L. Bernard, L. Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title | Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title_full | Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title_fullStr | Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title_full_unstemmed | Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title_short | Incidence, characteristics, and mortality of infective endocarditis in France in 2011 |
title_sort | incidence, characteristics, and mortality of infective endocarditis in france in 2011 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814232/ https://www.ncbi.nlm.nih.gov/pubmed/31652280 http://dx.doi.org/10.1371/journal.pone.0223857 |
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