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Document Details :
Title: Incidence and complication rate of infective endocarditis in the Dutch region of Walcheren
Subtitle: A 3-year retrospective study
Author(s): WALPOT, Jeroen , BLOK, Willem , VAN ZWIENEN, Jan , KLAZEN, Cees , AMSEL, Bram
Journal: Acta Cardiologica
Volume: 61 Issue: 2 Date: April 2006
Objective — To measure the incidence of infective endocarditis (IE) in the region of Walcheren and to estimate the complication and comorbidity rate of IE, we conducted a 3-year retrospective study of IE in the only hospital (Ziekenhuis Walcheren) of the region between January, 2002 and December, 2004.
Results — The total number of cases was 32.The calculated yearly incidence of IE was 9.61 cases per 100.000 inhabitants per year. The median age was 64 years (range 36-81 years). When applying the Duke criteria 28 patients (87.5%) were classified as definite IE and 4 patients (12.5%) as possible IE. Blood cultures were positive in 27 patients (84.4%). The most commonly isolated organisms were streptococci (37.5%). Staphylococcus aureus was isolated in 31.3% of positive blood cultures. Enteroccocus faecalis was identified in 3 cases (9.4%).
In only 15.6% of the cases was the course of IE uncomplicated.The most frequent complications were heart failure (59.4%) and embolic events (34.4%).Cardiac surgery was performed in 37.5% of the cases. Concomitant morbidity was found in 75% of the patients. Especially, the high incidences of diabetes mellitus (28.1%),chronic renal failure (28.1%) and chronic obstructive pulmonary disease (21.9%) were remarkable.
Conclusion — The calculated incidence of IE of 9.61 cases per 100,000 inhabitants per year was more than five times higher than the one reported in a nation-wide Dutch study of 1992.
The present study demonstrates that IE remains a disease with a considerable mortality and complication rate.The majority of the patients with IE had non-cardiac comorbidity.Especially, the prevalence of diabetes mellitus and chronic renal failure in our population of patients with IE is remarkable.