Table 1.
Baseline characteristics
| First-time diagnosis of infective endocarditis (IE) between 1999 and 2018 | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall (100%) | Valve surgery during admission N = 1981 (22.5%) | No valve surgery during admission N = 6823 (77.5%) | |||||||||
| 1999–2018 N = 8804 (100%) |
1999–2003 N = 360 (24.4%*) |
2004–2008 N = 483 (24.0%*) |
2009–2013 N = 553 (23.5%*) |
2014–2018 N = 585 (19.7%*) |
P value | 1999–2003 N = 1115 (75.6%*) |
2004–2008 N = 1528 (76.0%*) |
2009–2013 N = 1802 (76.5%*) |
2014–2018 N = 2378 (80.3%*) |
P value | |
| Age group | |||||||||||
| < 40 years | 596 (6.8%) | 48 (13.3%) | 42 (8.7%) | 49 (8.9%) | 48 (8.2%) | 0.024 | 124 (11.1%) | 109 (7.1%) | 92 (5.1%) | 84 (3.5%) | < 0.001 |
| 40–49 years | 613 (7.0%) | 47 (13.1%) | 57 (11.8%) | 69 (12.5%) | 49 (8.4%) | 0.031 | 93 (8.3%) | 106 (6.9%) | 103 (5.7%) | 89 (3.7%) | < 0.001 |
| 50–59 years | 1107 (12.6%) | 90 (25.0%) | 113 (23.4%) | 109 (19.7%) | 97 (16.6%) | < 0.001 | 133 (11.9%) | 161 (10.5%) | 183 (10.2%) | 221 (9.3%) | 0.017 |
| 60–69 years | 1893 (21.5) | 90 (25.0%) | 152 (31.5%) | 169 (30.6%) | 165 (28.2%) | 0.561 | 200 (17.9%) | 293 (19.2%) | 393 (21.8%) | 431 (18.1%) | 0.902 |
| 70–79 years | 2627 (29.8) | 76 (21.1%) | 103 (21.3%) | 133 (24.1%) | 199 (34.0%) | < 0.001 | 342 (30.7%) | 450 (29.5%) | 515 (28.6%) | 809 (34.0%) | 0.013 |
| > 79 years | 1968 (22.4%) | 9 (2.5%) | 16 (3.3%) | 24 (4.3%) | 27 (4.6%) | 0.071 | 223 (20.0%) | 409 (26.8%) | 516 (28.6%) | 744 (31.3%) | < 0.001 |
| Age (median, 25–75th percentile) | 70.8 (59.2–79.1) | 59.7 (49.6–69.1) | 62.2 (52.3–69.8) | 63.1 (52.3–71.6) | 66.9 (55.2- 73.0) | < 0.001 | 70.2 (55.2, 78.3) | 72.4 (60.2, 80.5) | 72.6 (63.0, 81.2) | 74.8 (65.8, 81.7) | < 0.001 |
| Male | 5762 (65.4%) | 244 (67.8%) | 352 (72.9%) | 431 (77.9%) | 425 (72.6%) | 0.008 | 640 (57.4%) | 935 (61.2%) | 1208 (67.0%) | 1525 (64.1%) | < 0.001 |
| Length of hospital admission (days, median, 25–75th percentile) | 42.0 (29.0, 52.0) | 55.0 (41.0–72.0) | 49.0 (38.0–66.0) | 48.0 (40.0–64.0) | 45 .0 (35.0–56.0) | < 0.001 | 39.0 (27.0–51.0) | 41.0 (26.0–52.0) | 39.0 (26.0–50.0) | 35.0 (25.0–47.0) | < 0.001 |
| Days from admission until surgery (days, median, 25–75th percentile) | – | 18.5 (8.0–34.0) | 13.0 (5.0–25.0) | 9.0 (4.0–20.0) | 6.0 (3.0–13.0) | < 0.001 | – | – | – | – | – |
| Extraction of a previously implanted CIED and valve surgery | 21 (0.2%) | < 4 (< 1.1%) | < 4 (< 0.8%) | 6 (1.1%) | 11 (1.9%) | 0.011 | – | – | – | – | – |
| Presumed isolated RS-IE1 | 466 (5.3%) | – | – | – | – | – | 33 (3.0%) | 68 (4.5%) | 157 (8.7%) | 208 (8.7%) | < 0.001 |
| Of them, extraction of a previously implanted CIED and no valve surgery | 367 (78.8%) | – | – | – | – | – | 4 (12.1%) | 50 (7.4%) | 133 (84.7%) | 180 (86.5%) | < 0.001 |
| Of them, more than half of admission at an infectious disease ward and no valve surgery | 99 (21.4%) | – | – | – | – | – | 29 (87.9%) | 18 (26.5%) | 24 (15.3%) | 28 (13.5%) | 0.314 |
| Comorbidity, medical history of: | |||||||||||
| Prosthetic heart valve (prior to admission) | 1450 (16.5%) | 26 (7.2%) | 50 (10.4%) | 93 (16.8%) | 117 (20.0%) | < 0.001 | 78 (7.0%) | 212 (13.9%) | 346 (19.2%) | 528 (22.2%) | < 0.001 |
| Of them, number, and proportion of TAVI | 176 (12.1%) | 0 (0.0%) | 0 (0.0%) | < 4 (< 4.3%) | 5 (4.3% | 0.012 | 0 (0.0%) | 0 (0.0%) | 33 (9.5%) | 136 (25.8%) | < 0.001 |
| Diabetes | 1739 (19.8%) | 34 (9.4%) | 47 (9.7%) | 85 (15.4%) | 105 (17.9%) | < 0.001 | 145 (13.0%) | 258 (16.9%) | 406 (22.5%) | 659 (27.7%) | < 0.001 |
| Renal disease | 1159 (13.2%) | 20 (5.6%) | 31 (6.4%) | 50 (9.0%) | 53 (9.1%) | 0.020 | 84 (7.5%) | 178 (11.6%) | 300 (16.6%) | 443 (18.6%) | < 0.001 |
| Dialysis2 | 495 (5.6%) | 7 (1.9%) | 14 (2.9%) | 26 (4.7%) | 24 (4.1%) | 0.042 | 28 (2.5%) | 93 (6.1%) | 134 (7.4%) | 169 (7.1%) | < 0.001 |
| Liver disease | 622 (7.1%) | 20 (5.6%) | 26 (5.4%) | 22 (4.0%) | 30 (5.1%) | 0.603 | 70 (6.3%) | 108 (7.1%) | 141 (7.8%) | 205 (8.6%) | 0.009 |
| CIED2 | 1066 (12.2%) | 4 (1.1%) | 15 (3.1%) | 26 (4.7%) | 36 (6.2%) | < 0.001 | 24 (2.2%) | 134 (8.7%) | 321 (17.8%) | 507 (21.3%) | < 0.001 |
| Atrial fibrillation/flutter | 2105 (23.9%) | 40 (11.1%) | 55 (11.4%) | 80 (14.5%) | 99 (16.9%) | 0.003 | 184 (16.5%) | 328 (21.5%) | 515 (28.6%) | 804 (33.8%) | < 0.001 |
| Congestive heart failure | 1946 (22.1%) | 41 (11.4%) | 66 (13.7%) | 80 (14.5%) | 66 (11.3%) | 0.848 | 223 (20.0%) | 345 (22.6%) | 486 (27.0%) | 639 (26.9%) | < 0.001 |
| Myocardial infarction | 1014 (11.5%) | 14 (3.9%) | 26 (5.4%) | 36 (6.5%) | 38 (6.5%) | 0.081 | 106 (9.5%) | 197 (12.9%) | 265 (14.7%) | 332 (14.0%) | < 0.001 |
| Disease of the mitral valve | 783 (8.9%) | 46 (12.8%) | 43 (8.9%) | 50 (9.0%) | 44 (7.5%) | 0.015 | 110 (9.9%) | 134 (8.8%) | 146 (8.1%) | 210 (8.8%) | 0.374 |
| Disease of the aortic valve | 2296 (26.1%) | 63 (17.5%) | 112 (23.2%) | 155 (28.0%) | 195 (33.3%) | < 0.001 | 191 (17.1%) | 314 (20.5%) | 510 (28.3%) | 756 (31.8%) | < 0.001 |
| Ischemic/haemorrhagic stroke | 1061 (12.0%) | 14 (3.9%) | 33 (6.8%) | 45 (8.1%) | 52 (8.9%) | 0.004 | 103 (9.2%) | 180 (11.8%) | 265 (14.7%) | 369 (15.5%) | < 0.001 |
| Chronic obstructive lung disease | 1054 (12.0%) | 18 (5.0%) | 32 (6.6%) | 43 (7.8%) | 45 (7.7%) | 0.102 | 130 (11.7%) | 192 (12.6%) | 266 (14.8%) | 328 (13.8%) | 0.046 |
| Malignancy | 1623 (18.4%) | 37 (10.3%) | 45 (9.3%) | 57 (10.3%) | 95 (16.2%) | 0.002 | 164 (14.7%) | 270 (17.7%) | 366 (20.3%) | 589 (24.8%) | < 0.001 |
| Drug abuse | 147 (1.7%) | < 4 (< 1.1%) | < 4 (< 0.8%) | 4 (0.7%) | < 4 (< 0.7%) | 0.413 | 22 (2.0%) | 27 (1.8%) | 22 (1.2%) | 26 (1.1%) | 0.017 |
| Pharmacotherapy within 6 months prior to hospital admission | |||||||||||
| Hypertension | 4261 (48.4%) | 93 (25.8%) | 179 (37.1%) | 233 (42.1%) | 241 (41.2%) | < 0.001 | 409 (36.7%) | 750 (49.1%) | 1027 (57.0%) | 1329 (55.9%) | < 0.001 |
| Glucose lowering medication | 1351 (15.3%) | 28 (7.8%) | 37 (7.7%) | 70 (12.7%) | 82 (14.0%) | < 0.001 | 113 (10.1%) | 199 (13.0%) | 318 (17.6%) | 504 (21.2%) | < 0.001 |
| Lipid lowering medication | 2674 (30.4%) | 26 (7.2%) | 104 (21.5%) | 164 (29.7%) | 195 (33.3%) | < 0.001 | 82 (7.4%) | 387 (25.3%) | 711 (39.5%) | 1005 (42.3%) | < 0.001 |
| Oral anticoagulants | 2137 (24.3%) | 48 (13.3%) | 74 (15.3%) | 105 (18.9%) | 133 (22.7%) | < 0.001 | 178 (15.9%) | 323 (21.1%) | 458 (25.4%) | 818 (34.4%) | < 0.001 |
This table shows the associated covariates (comorbidities and pharmacotherapy) for patients with infective endocarditis per calendar period (1999–2003, 2004–2008, 2009–2013, 2014–2018) subdivided by valve surgery during admission
CIED, cardiac implantable electronic device, RS-IE, right-sided infective endocarditis
Percentage marked with “*” is calculated as the number of patients with/without valve surgery per calendar period relative to the total number of patients per calendar period
1Patients were presumed having right sided IE if more than half of their current admission was at an infectious disease ward or if they had a prior CIED and subsequently underwent an extraction during admission
2Data on dialysis and CIED was available from ≥ 2000