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Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN.

Abstract

BACKGROUND

The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted.

METHODS

This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013.

RESULTS

We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P = .222) but was significantly higher in males and those of older age (P < .001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester.

CONCLUSION

In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.

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  • Authors+Show Affiliations

    ,

    Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: desimone.daniel@mayo.edu.

    ,

    Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Infectious Diseases, King Fahd Medical Center, Riyadh, Saudi Arabia.

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    Prairie Cardiovascular Consultants, Carbondale, IL.

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    Divisions of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN.

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    Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN.

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    Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Divisions of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN.

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    Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

    ,

    Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

    Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

    Source

    American heart journal 170:4 2015 Oct pg 830-6

    MeSH

    Adolescent
    Adult
    Aged
    Endocarditis
    Female
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Minnesota
    Morbidity
    Population Surveillance
    Retrospective Studies
    Risk Factors
    Time Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26386808

    Citation

    DeSimone, Daniel C., et al. "Temporal Trends in Infective Endocarditis Epidemiology From 2007 to 2013 in Olmsted County, MN." American Heart Journal, vol. 170, no. 4, 2015, pp. 830-6.
    DeSimone DC, Tleyjeh IM, Correa de Sa DD, et al. Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. Am Heart J. 2015;170(4):830-6.
    DeSimone, D. C., Tleyjeh, I. M., Correa de Sa, D. D., Anavekar, N. S., Lahr, B. D., Sohail, M. R., ... Baddour, L. M. (2015). Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. American Heart Journal, 170(4), pp. 830-6. doi:10.1016/j.ahj.2015.07.007.
    DeSimone DC, et al. Temporal Trends in Infective Endocarditis Epidemiology From 2007 to 2013 in Olmsted County, MN. Am Heart J. 2015;170(4):830-6. PubMed PMID: 26386808.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. AU - DeSimone,Daniel C, AU - Tleyjeh,Imad M, AU - Correa de Sa,Daniel D, AU - Anavekar,Nandan S, AU - Lahr,Brian D, AU - Sohail,Muhammad R, AU - Steckelberg,James M, AU - Wilson,Walter R, AU - Baddour,Larry M, Y1 - 2015/07/17/ PY - 2015/05/04/received PY - 2015/07/11/accepted PY - 2015/9/21/entrez PY - 2015/9/21/pubmed PY - 2015/12/17/medline SP - 830 EP - 6 JF - American heart journal JO - Am. Heart J. VL - 170 IS - 4 N2 - BACKGROUND: The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted. METHODS: This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013. RESULTS: We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P = .222) but was significantly higher in males and those of older age (P < .001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester. CONCLUSION: In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/26386808/Temporal_trends_in_infective_endocarditis_epidemiology_from_2007_to_2013_in_Olmsted_County_MN_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(15)00444-5 DB - PRIME DP - Unbound Medicine ER -