Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN - 18/09/15
, Imad M. Tleyjeh, MD, MSc a, b, Daniel D. Correa de Sa, MD c, Nandan S. Anavekar, MB, BCh d, Brian D. Lahr, MS e, Muhammad R. Sohail, MD a, d, James M. Steckelberg, MD a, Walter R. Wilson, MD a, Larry M. Baddour, MD aRiassunto |
Background |
The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted.
Methods |
This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013.
Results |
We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P = .222) but was significantly higher in males and those of older age (P < .001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non–Olmsted County patients treated at Mayo Clinic Rochester.
Conclusion |
In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non–population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.
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| Author contributions: Dr DeSimone had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; design and conduct of the study: DeSimone, Steckelberg, and Wilson, Baddour; acquisition of data: DeSimone, Steckelberg, Anavekar, Tleyjeh, Correa de Sa, and Baddour; analysis and interpretation of data: DeSimone, Sohail, Tleyjeh, Correa de Sa, Anavekar, Lahr, Wilson, and Baddour; critical revisions of the manuscript for important intellectual content: DeSimone, Sohail, Tleyjeh, Correa de Sa, Lahr, Steckelberg, Anavekar, Wilson, and Baddour; drafting of the manuscript: DeSimone, Wilson, and Baddour; statistical analysis: DeSimone, Lahr, and Baddour; obtained funding: DeSimone, Wilson, and Baddour; administrative, technical, or material support: Wilson, Steckelberg, and Baddour; study supervision: DeSimone, Steckelberg, Wilson, and Baddour. |
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| Financial disclosures: Sohail: TyRx Inc (Monmouth Junction, NJ) (moderate, less than $10,000); Baddour: royalty payments, UpToDate, Inc (Philadelphia, PA); editor-in-chief payments, Massachusetts Medical Society (Journal Watch Infectious Diseases) (Waltham, MA). |
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| Conflict of interest: none. |
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| Funding/support: This study was supported by research grants from the Edward C Rosenow III, MD, Professorship in the Art of Medicine, Mayo Foundation for Medical Education and Research (Rochester, MN). This study was made possible using the resources of the REP, which is supported by the National Institute on Aging of the NIH under award number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. |
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| Role of the sponsor: The funding organizations had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript. |
Vol 170 - N° 4
P. 830-836 - ottobre 2015 Ritorno al numero
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