• JAMA · Jul 2002

    Changing profile of infective endocarditis: results of a 1-year survey in France.

    • Bruno Hoen, François Alla, Christine Selton-Suty, Isabelle Béguinot, Anne Bouvet, Serge Briançon, Jean-Paul Casalta, Nicolas Danchin, François Delahaye, Jerome Etienne, Vincent Le Moing, Catherine Leport, Jean-Luc Mainardi, Raymond Ruimy, François Vandenesch, and Association pour l'Etude et la Prévention de l'Endocardite Infectieuse (AEPEI) Study Group.
    • Service de Maladies Infectieuses et Tropicales, University of Besançon Medical Center, Centre Hospitalier Universitaire de Besançon, F-25030 Besançon Cedex, France. bruno.hoen@ufc-chu.univ-fcomte.fr
    • JAMA. 2002 Jul 3; 288 (1): 75-81.

    ContextSince the first modern clinical description of infective endocarditis (IE) at the end of the 19th century, the profile of the disease has evolved continuously, as highlighted in epidemiological studies including a French survey performed in 1991.ObjectiveTo update information gained from the 1991 study on the epidemiology of IE in France.Design And SettingPopulation-based survey conducted from January through December 1999 in all hospitals in 6 French regions representing 26% of the population (16 million inhabitants).PatientsThree hundred ninety adult inpatients diagnosed with IE according to Duke criteria.Main Outcome MeasuresIncidence of IE; proportion of patients with underlying heart disease; clinical characteristics; causative microorganisms; surgical and mortality outcomes.ResultsThe annual age- and sex-standardized incidence was 31 (95% confidence interval [CI], 28-35) cases per million, not including the region of New Caledonia, which had 161 (95% CI, 117-216) cases per million. There was no previously known heart disease in 47% of the cases. The proportion of prosthetic-valve IE was 16%. Causative microorganisms were: streptococci, 48% (group D streptococci, 25%; oral streptococci, 17%, pyogenic streptococci, 6%); enterococci, 8%; Abiotrophia species, 2%; staphylococci, 29%; and other or multiple pathogens, 8%. Blood cultures were negative in 9% and no microorganism was identified in 5% of the cases. Early valve surgery was performed in 49% of the patients. In-hospital mortality was 16%. Compared with 1991, this study showed a decreased incidence of IE in patients with previously known underlying heart disease (20.6 cases per million vs 15.1 cases per million; P<.001); a smaller incidence of oral streptococcal IE (7.8 cases per million vs 5.1 cases per million; P<.001), compensated by a larger proportion of IE due to group D streptococci (5.3 cases per million vs 6.2 cases per million; P =.67) and staphylococci (4.9 cases per million vs 5.7 cases per million; P =.97); an increased rate of early valve surgery (31.2% vs 49.7%; P<.001); and a decreased in-hospital mortality rate (21.6% vs 16.6%; P =.08).ConclusionAlthough the incidence of IE has not changed, important changes in disease characteristics, treatment, and outcomes were noted.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…