Infective endocarditis in the U.S., 1998-2009: a nationwide study

Area of Science:

• Infectious Diseases
• Cardiology
• Epidemiology

Background:

• Previous estimates of infective endocarditis incidence in the U.S. were based on limited local data.
• These studies suggested an annual incidence of approximately 4 cases per 100,000 population.

Purpose of the Study:

• To determine the national incidence and trends of infective endocarditis hospitalizations in the U.S. from 1998 to 2009.
• To analyze associated bacteriology, comorbidities, outcomes, and costs.

Main Methods:

• Utilized the Nationwide Inpatient Sample (1998-2009) to analyze approximately 8 million U.S. hospitalizations annually.
• Examined trends in endocarditis admissions, patient demographics, pathogens, and clinical outcomes.

Main Results:

• Endocarditis hospitalizations increased from 25,511 in 1998 to 38,976 in 2009, with an annual age-adjusted admission rate increase of 2.4%.
• The proportion of patients with cardiac devices rose, while drug use and HIV decreased; Staphylococcus aureus, particularly MRSA, became the most common pathogen.
• Mortality remained stable around 14.5%, but complications like stroke and myocardial infarction increased.

Conclusions:

• Infective endocarditis is more prevalent and increasing in the U.S. than previously thought.
• Preventive strategies should prioritize device-associated and healthcare-associated infections.