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Sex differences in infective endocarditis: a Danish nationwide study
Anna Stahl1, Lauge Østergaard2, Eva Havers-Borgersen2
1The Heart Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark. annastahl118@gmail.com.
Infection
|October 24, 2023
Summary
Female patients with infective endocarditis (IE) face higher in-hospital mortality but similar long-term survival compared to males. This study highlights sex-based differences in IE characteristics and management.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Sex differences in infective endocarditis (IE) are noted, yet patient characteristics and outcomes remain sparsely documented.
- Conflicting data on sex-associated short-term IE outcomes necessitate further large-scale investigation.
Purpose of the Study:
- To comprehensively characterize sex disparities in IE.
- To analyze differences in patient demographics, frailty, microbiology, socioeconomic status, treatment, and outcomes on a national level.
Main Methods:
- Utilized Danish national registries (2010-2020) to identify IE patients via ICD codes and lab reports.
- Assessed frailty using the Hospital Frailty Risk Score.
- Employed logistic and Cox regression for adjusted mortality analyses.
Main Results:
- Included 6259 IE patients (32.7% female). Female patients were older, more frail, and had fewer Enterococcus-IE cases.
- Female patients received surgery less frequently (14.0% vs. 21.2%).
- Female sex correlated with increased in-hospital mortality (adj. OR 1.33), but not 1- or 5-year post-discharge mortality.
Conclusions:
- Female sex is linked to higher in-hospital mortality in IE patients.
- Differences observed include lower Enterococcus-IE prevalence and reduced surgical intervention rates in females.
- Further research is required to elucidate the underlying reasons for these observed sex-based disparities.
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