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Table 1 The clinical characteristics of infective endocarditis and changing trends by years from 2007 to 2016

From: Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China 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
Male262 (64.4)40 (64.5)42 (66.7)53 (67.9)56 (62.9)71 (61.7).513
Age,mean ± SD48 ± 1645 ± 1542 ± 1547 ± 1650 ± 1652 ± 16.001
Comorbidities
 Hypertension82 (20.1)9 (14.5)9 (14.3)11 (14.1)20 (22.5)33 (28.7).005
 Diabetes mellitus37 (9.1)3 (4.8)5 (7.9)6 (7.7)8 (9.0)15 (13.0).078
 Hepatitis B virus infection18 (4.4)1 (1.6)2 (3.2)5 (6.4)6 (6.7)4 (3.5).501
 Chronic organ disease23 (5.7)3 (4.8)3 (4.8)2 (2.6)6 (6.7)9 (7.8).260
 Cancer12 (2.9)2 (3.2)2 (3.2)4 (5.1)2 (2.2)2 (1.7).474
 No-underlying heart disease186 (45.7)18 (29.0)29 (46.0)42 (53.8)40 (44.9)57 (49.6).044
 Underlying heart disease221 (54.3)44 (71.0)34 (54.0)36 (46.2)49 (55.1)58 (50.4).044
 Congenital heart disease105 (25.8)17 (27.4)16 (25.4)18 (23.1)26 (29.2)28 (24.3).870
 Rheumatic heart disease69 (17.0)22 (35.5)14 (22.2)12 (15.4)6 (6.7)15 (13.0)<.001
 Previous cardiac surgery44 (10.8)11 (17.7)6 (9.5)6 (7.7)15 (16.9)6 (5.2).086
 Degenerative heart disease13 (3.2)002 (2.6)2 (2.2)9 (7.8).001
 Hospital stay, mean ± SD25 ± 2231 ± 3132 ± 2523 ± 1723 ± 2421 ± 15.001
 Duration of Symptoms before echocardiography median (IQR),days13 (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),days25 (12–62)26 (12–68)24 (9–42)25 (14–62)28 (10–75)26 (13–62).434
 Previous antibiotic use321 (81.7)48 (81.4)58 (92.1)65 (90.3)76 (85.4)74 (67.3).001
 Intravenous drug abuse3 (0.7)1 (1.6)1 (1.6)001 (0.9).556
Symptoms and signs
 Fever365 (89.7)57 (91.9)57 (90.5)70 (89.7)83 (93.3)98 (85.2).233
 Anemia222 (54.5)38 (61.3)43 (68.3)43 (55.1)58 (65.2)40 (38.4)<.001
 Osler nodule7 (1.7)2 (3.2)03 (3.8)2 (2.2)0.288
 Janeway lesions or nailbed bleeding4 (0.9)1 (1.6)3 (4.8)000.060
 TEE52 (12.8)3 (4.8)4 (6.3)5 (6.4)8 (9.0)32 (27.8)<.001
Infection site      .342
 Left-side356 (87.5)53 (85.5)54 (85.7)67 (85.9)79 (88.8)103 (89.6) 
 Right-side31 (7.6)7 (11.3)3 (4.8)8 (10.3)4 (4.5)9 (7.8) 
 Left+ Right-side20 (4.9)2 (3.2)6 (9.5)3 (3.8)6 (6.7)3 (2.6) 
Infection valve      >.05
 Single valve295 (72.5)38 (61.3)46 (73.0)55 (70.5)58 (65.2)98 (85.2).002
 Mitral valve134 (32.9)16 (25.8)20 (31.7)24 (30.8)30 (33.7)44 (38.3) 
 Aortic valve143 (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 intima33 (8.1)11 (17.7)2 (3.2)10 (12.8)7 (7.9)3 (2.6) 
Type of IE
Native valve IE370 (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 IE37 (9.1)12 (19.3)5 (7.9)6 (7.7)12 (13.5)2 (1.7).002
Complications
 Embolic events125 (30.7)14 (22.6)16 (25.4)16 (20.5)34 (38.2)45 (39.1).003
 Cerebral embolism74 (18.2)6 (9.7)7 (11.1)12 (15.4)18 (20.2)31 (27.0).001
 Heart failure215 (52.8)31 (50.0)31 (49.2)43 (55.1)51 (57.3)59 (51.3).661
 Vegetation350 (86.0)44 (71.0)54 (85.7)62 (79.5)82 (92.1)108 (93.9)<.001
Vegetation length      <.001
 ≤10 mm90 (22.1)9 (14.5)12 (19.0)16 (20.5)21 (23.6)32 (27.8) 
 >10 mm<20 mm197 (48.4)25 (40.3)31 (49.2)31 (39.7)52 (58.4)58 (50.4) 
 ≥20 mm ≤ 30 mm51 (12.5)8 (12.9)10 (15.9)14 (17.9)6 (6.7)13 (11.3) 
 >30 mm12 (2.9)2 (3.2)1 (1.6)1 (1.3)3 (3.4)5 (4.3) 
Valvular perforation72 (17.8)3 (4.9)7 (11.1)11 (14.3)21 (23.6)30 (26.1)<.001
Perivalvular abscess30 (7.4)01 (1.6)3 (3.9)12 (13.5)14 (12.2)<.001
Positive rate blood culture222 (54.5)41 (66.1)33 (52.4)36 (46.2)44 (49.4)68 (59.1).663
Streptococci100 (24.6)17 (27.4)9 (14.3)15 (19.2)20 (22.5)39 (33.9).028*
Staphylococci80 (19.7)14 (22.6)17 (27.0)12 (15.4)15 (16.9)22 (19.1).668*
Enterococci5 (1.2)1 (1.6)1 (1.6)1 (1.3)1 (1.1)1 (0.9).051*
Surgical indications403 (99.0)60 (96.8)63 (100.0)76 (97.4)89 (100.0)115 (100.0).061
Surgical treatment235 (57.7)36 (58.1)34 (54.0)44 (56.4)58 (65.2)63 (54.8).900
In-hospital mortality43 (10.6)12 (19.4)3 (4.8)2 (2.6)10 (11.2)16 (13.9).910
One-year mortality46 (11.3)13 (21.0)3 (4.8)4 (5.1)10 (11.2.)16 (13.9).868
  1. * percentage accouting for the positive results in each group
  2. SD Standard deviation, IQR Interquartile range, IE Infective endocarditis, TEE Transesophageal echocardiography