Baddour Larry M, Shafiyi Aylin, Lahr Brian D, Anavekar Nandan S, Steckelberg James M, Wilson Walter R, Sohail M Rizwan, DeSimone Daniel C
Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN; Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN.
Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN.
Mayo Clin Proc. 2021 Jun;96(6):1438-1445. doi: 10.1016/j.mayocp.2020.08.044. Epub 2021 Mar 5.
To develop a contemporary profile of infective endocarditis (IE) among a population in 6 counties of Olmsted, Dodge, Mower, Steele, Waseca, and Freeborn in southern Minnesota between 2014 and 2018.
All possible and definite cases of IE (≥18 years) among residents of 6 counties in southern Minnesota, including Olmsted County, diagnosed between January 1, 2014, and December 31, 2018, were included in this retrospective, population-based investigation, using the Expanded Rochester Epidemiology Project (E-REP).
Overall, 137 patients with IE developed incident IE in the 6-county region, corresponding to an age- and sex-adjusted incidence rate of 11.9 per 100,000 person-years. Men had a significantly higher incidence of IE (17.9 vs 6.8 per 100,000 person-years), and rates increased exponentially with age in both sexes. The median age of incident cases was 68.2 years, and 67.9% were male patients. The percentage of patients with histories of injection-drug use was low, at 6.7%. Bicuspid aortic valve was the most common (9.6%) native valve predisposing condition. Staphylococcus aureus was identified as the predominant pathogen in the overall group (34.8%), with viridans-group streptococci accounting for only 19.3% cases. Central nervous system and musculoskeletal complications were common. The 30-day readmission rate was 27.9%, and the 6-month mortality rate was 31.8%.
To our knowledge, this is the first time that the population-based E-REP has been used to determine an age- and sex-adjusted IE incidence. Older male patients predominated, and S aureus was the most common pathogen. Based on these findings, it is not surprising that IE complications were frequently seen.
了解2014年至2018年间明尼苏达州南部奥姆斯特德、道奇、莫厄、斯蒂尔、韦塞卡和弗里伯恩6个县人群中感染性心内膜炎（IE）的当代概况。
本回顾性、基于人群的调查使用扩展罗切斯特流行病学项目（E-REP），纳入2014年1月1日至2018年12月31日期间明尼苏达州南部6个县（包括奥姆斯特德县）居民中所有可能的和确诊的IE病例（≥18岁）。
总体而言，6县地区有137例患者发生了IE，年龄和性别调整后的发病率为每10万人年11.9例。男性IE发病率显著更高（每10万人年17.9例对6.8例），且两性发病率均随年龄呈指数增长。发病病例的中位年龄为68.2岁，男性患者占67.9%。有注射吸毒史的患者比例较低，为6.7%。二叶式主动脉瓣是最常见的（9.6%）导致IE的自身瓣膜病变情况。金黄色葡萄球菌被确定为总体组中的主要病原体（34.8%），草绿色链球菌仅占病例的19.3%。中枢神经系统和肌肉骨骼并发症很常见。30天再入院率为27.9%，6个月死亡率为31.8%。
据我们所知，这是首次使用基于人群的E-REP来确定年龄和性别调整后的IE发病率。老年男性患者居多，金黄色葡萄球菌是最常见的病原体。基于这些发现，IE并发症常见也就不足为奇了。
