Endocarditis epidemiology and demographics: Difference between revisions

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{{Endocarditis}}
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==Overview==
The [[incidence]] of native valve infective [[endocarditis]] is approximately 1.7-6.2 cases per 100,000 individuals per year in the United States and Europe. The [[prevalence]] of [[infective endocarditis]] among [[IV drug]] users ranges from 10 to 15%.The [[incidence]] of [[endocarditis]] increases with age; the median age of patients is 47 to 69 years. There is an increased [[incidence]] of [[infective endocarditis]] in persons 65 years of age and older. Males are more commonly affected with [[endocarditis]] than females. The male to female ratio is approximately 1.7:1.


==Incidence==
==Epidemiology and Demographics==
The incidence of infective endocarditis is approximately 2-4 cases per 100,000 persons per year worldwide. This rate has not changed in the past 5-6 decades.
===Incidence===


==Age==
* The [[incidence]] of native [[valve]] [[infective endocarditis]] is approximately 1.7-6.2 cases per 100,000 individuals per year in the United States and Europe.<ref name="pmid11794152">{{cite journal| author=Mylonakis E, Calderwood SB| title=Infective endocarditis in adults. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 18 | pages= 1318-30 | pmid=11794152 | doi=10.1056/NEJMra010082 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11794152  }} </ref>
Infective endocarditis may occur in a person of any age. The frequency is increasing in elderly individuals, with 25-50% of cases occurring in those older than 60 years of age.


==Gender==
===Age===
Infective endocarditis is 3 times more common in males than in females.


==Changes in Bacterial Species Causing Endocarditis==
* The [[incidence]] of infective [[endocarditis]] increases with age; the median age of patients is 47 to 69 years.
There has been a decline in [[strepococcus viridans]] endocarditis and an increase in stphylococcal endocarditis.
* There is an increased [[incidence]] of infective endocarditis in persons 65 years of age and older.
*The incidence of [[nonbacterial thrombotic endocarditis]] increases with age; the median age of patients is 40 to 70 years.<ref name="pmid13403513">{{cite journal |vauthors=MACDONALD RA, ROBBINS SL |title=The significance of nonbacterial thrombotic endocarditis:  an autopsy and clinical study of 78 cases |journal=Ann. Intern. Med. |volume=46 |issue=2 |pages=255–73 |date=February 1957 |pmid=13403513 |doi=10.7326/0003-4819-46-2-255 |url=}}</ref>


==Risk Factors for Endocarditis==
===Gender===
Adults and children with underlying cardiac conditions placing them at ''highest risk'' for adverse outcomes of infective endocarditis (IE) including those with:
* Prosthetic cardiac valve or prosthetic cardiac valve repair
* Previous infective endocarditis
* Congenital heart disease (CHD) associated with
** Unrepaired cyanotic CHD, including palliative shunts and conduits
** Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
** Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
* Cardiac transplantation patients who develop cardiac valvulopathy


==What is the incidence among patients who do not use illicit drugs and have a [[fever]] in the emergency room?==
* Males are more commonly affected with [[endocarditis]] than females.<ref name="pmid11794152" />
There is less than a 5% chance of occult endocarditis. Mellors <ref name=Mellors>.</ref> in 1987 found no cases of endocarditis nor of [[staphylococcal]] bacteremia among 135 febrile patients ''in the emergency room''. The upper [http://medinformatics.uthscsa.edu/calculator/calc.shtml confidence interval] for an incidence of 0% among 135 patients is 5%, statistically there is ''up to'' a 5% chance of endocarditis among these patients. In contrast, Leibovici <ref name=Leibovici>.</ref> found that among 113 non-selected adults ''admitted to the hospital'' because of fever there were two cases (1.8% with 95%CI: 0% to 7%) of [[endocarditis]].
* The male to female ratio is approximately 1.7:1.
 
==What is the incidence among patients who do use illicit drugs and have a fever in the emergency room?==
There is about a 10% to 15% prevalence of [[endocarditis]]. This estimate is not substantially changed by whether the doctor believes the patient has a trivial explanation for their fever<ref name=Marantz>.</ref>. Weisse<ref name=Weisse>.</ref> found that 13% of 121 patients had endocarditis. Marantz <ref name=Marantz>.</ref> also found a prevalence of endocarditis of 13% among such patients in the emergency room with fever. Samet <ref name=Samet>.</ref> found a 6% incidence among 283 such patients, but after excluding patients with initially apparent major illness to explain the fever (including 11 cases of manifest endocarditis), there was a 7% prevalence of endocarditis.
 
==What is the incidence among patients with staphylococcal bacteremia (SAB)==
One study found a 29% prevalence of [[endocarditis]] in community-acquired SAB versus 5% in nosocomial SAB<ref name=Kaech>{{cite journal | author = Kaech C, Elzi L, Sendi P, Frei R, Laifer G, Bassetti S, Fluckiger U | title = Course and outcome of Staphylococcus aureus bacteraemia: a retrospective analysis of 308 episodes in a Swiss tertiary-care centre. | journal = Clin Microbiol Infect | volume = 12 | issue = 4 | pages = 345-52 | year = 2006 | id = PMID 16524411 | doi=10.1111/j.1469-0691.2005.01359.x}}</ref>. However, only 2% of strains were resistant to [[methicillin]] and so these numbers may be low in areas of higher resistance.


==References==
==References==
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Latest revision as of 02:04, 6 March 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]

Overview

The incidence of native valve infective endocarditis is approximately 1.7-6.2 cases per 100,000 individuals per year in the United States and Europe. The prevalence of infective endocarditis among IV drug users ranges from 10 to 15%.The incidence of endocarditis increases with age; the median age of patients is 47 to 69 years. There is an increased incidence of infective endocarditis in persons 65 years of age and older. Males are more commonly affected with endocarditis than females. The male to female ratio is approximately 1.7:1.

Epidemiology and Demographics

Incidence

Age

Gender

  • Males are more commonly affected with endocarditis than females.[1]
  • The male to female ratio is approximately 1.7:1.

References

  1. 1.0 1.1 Mylonakis E, Calderwood SB (2001). "Infective endocarditis in adults". N Engl J Med. 345 (18): 1318–30. doi:10.1056/NEJMra010082. PMID 11794152.
  2. MACDONALD RA, ROBBINS SL (February 1957). "The significance of nonbacterial thrombotic endocarditis: an autopsy and clinical study of 78 cases". Ann. Intern. Med. 46 (2): 255–73. doi:10.7326/0003-4819-46-2-255. PMID 13403513.

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