Table 1.
Comparison of demographic characteristics and predisposing factors of endocarditis in patients with health care-associated native valve endocarditis and those with community-acquired infection
| All NVE
|
p value | Health care-associated NVE
|
p value | |||
|---|---|---|---|---|---|---|
| Community-acquired (n=1065) | Health care-associated (n=557) | Nosocomial (n=303) | Non-nosocomial (n=254) | |||
| Median age, years (IQR) | 58 (44–71) | 63 (50–73) | < 0.001 | 66 (52–75) | 58 (46–69) | < 0.001 |
| Male | 769/1063 (72%) | 352/557 (63%) | < 0.001 | 195/303 (64%) | 157/254 (62%) | 0.001 |
| Region: | ||||||
| - United States | 133/324 (41%) | 191/324 (59%) | < 0.001 | 67/191(35%) | 124/191 (65%) | < 0.001 |
| - Europe | 511/734 (70%) | 223/734 (30%) | 15/27 (56%) | 12/27 (44%) | ||
| - South America | 120/164 (73%) | 44/164 (27%) | 28/44 (64%) | 16/44 (36%) | ||
| - Australia/New Zealand | 249/318 (78%) | 69/318 (22%) | 40/69 (58%) | 29/69 (42%) | ||
| - Asia/Middle East | 47/74 (64%) | 27/74 (36%) | 150/223 (67%) | 73/223 (33%) | ||
| Comorbid condition: | ||||||
| - Hemodialysis | NA* | 166/556 (63%) | NA* | 28/302 (9%) | 138/254 (54%) | < 0.001 |
| - Diabetes mellitus | 142/1064 (13%) | 137/551 (25%) | < 0.001 | 60/301 (20%) | 77/250 (31%) | 0.003 |
| - Cancer | 74/1062(7%) | 88/557 (16%) | < 0.001 | 46/303 (15%) | 42/254 (17%) | 0.66 |
| - Immunosuppressive therapy | 44/1057 (4%) | 81/556 (15%) | < 0.001 | 33/303 (11%) | 48/253 (19%) | 0.007 |
| Cardiac predisposing conditions: | ||||||
| - Valvular disease† | 404/1057 (38%) | 187/552 (34%) | 0.086 | 114/300 (38%) | 73/252 (29%) | 0.026 |
| - History of congenital heart disease | 8/949 (1%) | 6/518 (1%) | 0.42 | 5/284 (2%) | 1/234 (0.4%) | 0.158 |
| - Previous IE episode | 41/1065 (4%) | 17//556 (3%) | 0.55 | 10/302 (3%) | 7/254 (3%) | 0.71 |
| Dental procedures | 117/904 (13%) | 37/436 (8%) | 0.017 | 17/245 (7%) | 20/191 (10%) | 0.189 |
| Other invasive procedures‡ | 70/999 (7%)§ | 214/509 (42%) | <0.001 | 136/283 (48%)** | 78/226 (35%)†† | 0.002 |
| Intravascular catheter present at the onset of symptoms: | NA‡‡ | 271/557 (49%) | NA‡‡ | 134/303 (44%) | 137/254 (54%) | 0.022 |
| - Peripheral catheter | NA | 102/548 (19%) | NA | 66/298 (22%) | 36/250 (14%) | 0.020 |
| - Short-term central catheter | NA | 103/556 (19%) | NA | 24/303 (8%) | 79/253 (31%) | <0.001 |
| - Chronic central catheter | NA | 89/554 (16%) | NA | 63/302 (21%) | 26/252 (10%) | <0.001 |
| - Peripherally inserted central catheter | NA | 23/547 (4%) | NA | 14/296 (5%) | 9/251 (4%) | 0.51 |
IE = infective endocarditis; IQR = interquartile ranges; NA= not applicable; NVE=native valve endocarditis
Study definition of community-acquired infection excludes the possibility of having an intravascular catheter.
“Valvular disease” refers to known underlying valvular heart disease (valve stenosis or regurgitation, usually related to rheumatic heart disease or degenerative lesions)
“Other invasive procedures” include any invasive procedure known to induce bacteremia performed 60 days before symptom onset, excluding dental manipulation. More than one procedure can have been performed to each patient
Invasive procedures included: colonoscopy 17 (24%), urologic manipulations 12 (17%), esophagogastroduodenoscopy 11 (16%), other 30 (43%)
Invasive procedures included: urologic manipulations 19 (14%), esophagogastroduodenoscopy 12 (9%), colonoscopy 9 (7%), cardiac catheterization 9 (7%), pacemarker implantacion 8 (6%), coronary artery bypass graft surgery 6 (4%), angiography (other than cardiac) 4 (3%), other 69 (51%)
Invasive procedures included: colonoscopy 10 (13%), chronic central catheter insertion 9 (12%), arteriovenous fistula for hemodialysis 8 (10%), esophagogastroduodenoscopy 6 (8%), urologic manipulations 4 (5%), vascular surgery 3 (4%), other 38 (49%)
Study definition of community-acquired infection excludes the possibility of undergoing hemodialysis.