Table 1 The clinical characteristics of infective endocarditis and changing trends by years from 2007 to 2016
Variable, n(%) | Total n = 407 | 2007–2008 n = 62 | 2009–2010 n = 63 | 2011–2012 n = 78 | 2013–2014 n = 89 | 2015–2016 n = 115 | P value |
|---|---|---|---|---|---|---|---|
Male | 262 (64.4) | 40 (64.5) | 42 (66.7) | 53 (67.9) | 56 (62.9) | 71 (61.7) | .513 |
Age,mean ± SD | 48 ± 16 | 45 ± 15 | 42 ± 15 | 47 ± 16 | 50 ± 16 | 52 ± 16 | .001 |
Comorbidities | |||||||
Hypertension | 82 (20.1) | 9 (14.5) | 9 (14.3) | 11 (14.1) | 20 (22.5) | 33 (28.7) | .005 |
Diabetes mellitus | 37 (9.1) | 3 (4.8) | 5 (7.9) | 6 (7.7) | 8 (9.0) | 15 (13.0) | .078 |
Hepatitis B virus infection | 18 (4.4) | 1 (1.6) | 2 (3.2) | 5 (6.4) | 6 (6.7) | 4 (3.5) | .501 |
Chronic organ disease | 23 (5.7) | 3 (4.8) | 3 (4.8) | 2 (2.6) | 6 (6.7) | 9 (7.8) | .260 |
Cancer | 12 (2.9) | 2 (3.2) | 2 (3.2) | 4 (5.1) | 2 (2.2) | 2 (1.7) | .474 |
No-underlying heart disease | 186 (45.7) | 18 (29.0) | 29 (46.0) | 42 (53.8) | 40 (44.9) | 57 (49.6) | .044 |
Underlying heart disease | 221 (54.3) | 44 (71.0) | 34 (54.0) | 36 (46.2) | 49 (55.1) | 58 (50.4) | .044 |
Congenital heart disease | 105 (25.8) | 17 (27.4) | 16 (25.4) | 18 (23.1) | 26 (29.2) | 28 (24.3) | .870 |
Rheumatic heart disease | 69 (17.0) | 22 (35.5) | 14 (22.2) | 12 (15.4) | 6 (6.7) | 15 (13.0) | <.001 |
Previous cardiac surgery | 44 (10.8) | 11 (17.7) | 6 (9.5) | 6 (7.7) | 15 (16.9) | 6 (5.2) | .086 |
Degenerative heart disease | 13 (3.2) | 0 | 0 | 2 (2.6) | 2 (2.2) | 9 (7.8) | .001 |
Hospital stay, mean ± SD | 25 ± 22 | 31 ± 31 | 32 ± 25 | 23 ± 17 | 23 ± 24 | 21 ± 15 | .001 |
Duration of Symptoms before echocardiography median (IQR),days | 13 (4–35) | 17 (7–48) | 14 (6–30) | 15 (4–40) | 9 (3–50) | 15 (4–31) | .542 |
Duration of symptoms before diagnosis, median (IQR),days | 25 (12–62) | 26 (12–68) | 24 (9–42) | 25 (14–62) | 28 (10–75) | 26 (13–62) | .434 |
Previous antibiotic use | 321 (81.7) | 48 (81.4) | 58 (92.1) | 65 (90.3) | 76 (85.4) | 74 (67.3) | .001 |
Intravenous drug abuse | 3 (0.7) | 1 (1.6) | 1 (1.6) | 0 | 0 | 1 (0.9) | .556 |
Symptoms and signs | |||||||
Fever | 365 (89.7) | 57 (91.9) | 57 (90.5) | 70 (89.7) | 83 (93.3) | 98 (85.2) | .233 |
Anemia | 222 (54.5) | 38 (61.3) | 43 (68.3) | 43 (55.1) | 58 (65.2) | 40 (38.4) | <.001 |
Osler nodule | 7 (1.7) | 2 (3.2) | 0 | 3 (3.8) | 2 (2.2) | 0 | .288 |
Janeway lesions or nailbed bleeding | 4 (0.9) | 1 (1.6) | 3 (4.8) | 0 | 0 | 0 | .060 |
TEE | 52 (12.8) | 3 (4.8) | 4 (6.3) | 5 (6.4) | 8 (9.0) | 32 (27.8) | <.001 |
Infection site | .342 | ||||||
Left-side | 356 (87.5) | 53 (85.5) | 54 (85.7) | 67 (85.9) | 79 (88.8) | 103 (89.6) | |
Right-side | 31 (7.6) | 7 (11.3) | 3 (4.8) | 8 (10.3) | 4 (4.5) | 9 (7.8) | |
Left+ Right-side | 20 (4.9) | 2 (3.2) | 6 (9.5) | 3 (3.8) | 6 (6.7) | 3 (2.6) | |
Infection valve | >.05 | ||||||
Single valve | 295 (72.5) | 38 (61.3) | 46 (73.0) | 55 (70.5) | 58 (65.2) | 98 (85.2) | .002 |
Mitral valve | 134 (32.9) | 16 (25.8) | 20 (31.7) | 24 (30.8) | 30 (33.7) | 44 (38.3) | |
Aortic valve | 143 (35.1) | 18 (29.0) | 23 (36.5) | 25 (32.1) | 27 (30.3) | 50 (43.5) | |
Multi-valve, n(%) | 79 (19.4) | 13 (21.0) | 15 (23.8) | 13 (16.7) | 24 (27.0) | 14 (12.2) | |
Endocardial or arterial intima | 33 (8.1) | 11 (17.7) | 2 (3.2) | 10 (12.8) | 7 (7.9) | 3 (2.6) | |
Type of IE | |||||||
Native valve IE | 370 (90.9) | 50 (80.6) | 58 (92.1) | 72 (92.3) | 77 (86.5) | 113 (98.3) | .002 |
Prosthetic valve IE or cardiac device–related IE | 37 (9.1) | 12 (19.3) | 5 (7.9) | 6 (7.7) | 12 (13.5) | 2 (1.7) | .002 |
Complications | |||||||
Embolic events | 125 (30.7) | 14 (22.6) | 16 (25.4) | 16 (20.5) | 34 (38.2) | 45 (39.1) | .003 |
Cerebral embolism | 74 (18.2) | 6 (9.7) | 7 (11.1) | 12 (15.4) | 18 (20.2) | 31 (27.0) | .001 |
Heart failure | 215 (52.8) | 31 (50.0) | 31 (49.2) | 43 (55.1) | 51 (57.3) | 59 (51.3) | .661 |
Vegetation | 350 (86.0) | 44 (71.0) | 54 (85.7) | 62 (79.5) | 82 (92.1) | 108 (93.9) | <.001 |
Vegetation length | <.001 | ||||||
≤10 mm | 90 (22.1) | 9 (14.5) | 12 (19.0) | 16 (20.5) | 21 (23.6) | 32 (27.8) | |
>10 mm<20 mm | 197 (48.4) | 25 (40.3) | 31 (49.2) | 31 (39.7) | 52 (58.4) | 58 (50.4) | |
≥20 mm ≤ 30 mm | 51 (12.5) | 8 (12.9) | 10 (15.9) | 14 (17.9) | 6 (6.7) | 13 (11.3) | |
>30 mm | 12 (2.9) | 2 (3.2) | 1 (1.6) | 1 (1.3) | 3 (3.4) | 5 (4.3) | |
Valvular perforation | 72 (17.8) | 3 (4.9) | 7 (11.1) | 11 (14.3) | 21 (23.6) | 30 (26.1) | <.001 |
Perivalvular abscess | 30 (7.4) | 0 | 1 (1.6) | 3 (3.9) | 12 (13.5) | 14 (12.2) | <.001 |
Positive rate blood culture | 222 (54.5) | 41 (66.1) | 33 (52.4) | 36 (46.2) | 44 (49.4) | 68 (59.1) | .663 |
Streptococci | 100 (24.6) | 17 (27.4) | 9 (14.3) | 15 (19.2) | 20 (22.5) | 39 (33.9) | .028* |
Staphylococci | 80 (19.7) | 14 (22.6) | 17 (27.0) | 12 (15.4) | 15 (16.9) | 22 (19.1) | .668* |
Enterococci | 5 (1.2) | 1 (1.6) | 1 (1.6) | 1 (1.3) | 1 (1.1) | 1 (0.9) | .051* |
Surgical indications | 403 (99.0) | 60 (96.8) | 63 (100.0) | 76 (97.4) | 89 (100.0) | 115 (100.0) | .061 |
Surgical treatment | 235 (57.7) | 36 (58.1) | 34 (54.0) | 44 (56.4) | 58 (65.2) | 63 (54.8) | .900 |
In-hospital mortality | 43 (10.6) | 12 (19.4) | 3 (4.8) | 2 (2.6) | 10 (11.2) | 16 (13.9) | .910 |
One-year mortality | 46 (11.3) | 13 (21.0) | 3 (4.8) | 4 (5.1) | 10 (11.2.) | 16 (13.9) | .868 |