Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second floor, No. 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran 1411713137, Iran.
Department of Pediatric Cardiology, Children's Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, No.62, Dr. Gharib's street, End of Keshavarz Boulevard, Tehran 1419733151, Iran.
Eur J Prev Cardiol. 2022 May 27;29(8):1287-1297. doi: 10.1093/eurjpc/zwab211.
Endocarditis accounts for significant morbidity and mortality. Timely diagnosis and prompt treatment are of paramount importance for optimal patient outcome. However, only few studies have assessed quality of care (QoC) in endocarditis. We aimed to describe QoC and changes in epidemiological features of endocarditis from 1990 to 2019.
Using primary indices of mortality, incidence, years of life lost, years lived with disability, and disability-adjusted life year, obtained from the Global Burden of Disease Study 2019, we calculated four secondary measures. Principal component analysis was performed to calculate QoC index (QCI), scored on a scale of 0-100 with higher values indicating better QoC, for different locations, age groups, and genders from 1990 to 2019. The all-ages incidence rate of endocarditis was estimated to increase significantly from 1990 to 2019, while mortality rate did not change. The age-standardized QCI was 73.6% globally, with higher values in high-income countries than in low-income countries. High-income North America (82.0%) and Asia Pacific (81.1%) had the highest QCI, whereas Eastern Europe (43.3%) had the lowest. Globally, the 30-49 and 95+ age groups had the highest (91.3%) and the lowest (71.7%) QCI, respectively. In most countries, particularly those with lower socio-demographic index, women had better QCI.
This is the first global assessment of QCI, shedding light on the current trends and highlighting the necessity of improving the endocarditis QoC, mainly by timely case detection, adherence to antibiotic prophylaxis guidelines, utilizing targeted antibiotics and advanced treatments, in the African region and resolving gender inequality in selected countries.
心内膜炎会导致严重的发病率和死亡率。及时诊断和及时治疗对于获得最佳患者结局至关重要。然而，只有少数研究评估了心内膜炎的医疗质量（QoC）。我们旨在描述 1990 年至 2019 年心内膜炎的 QoC 和流行病学特征的变化。
我们使用来自 2019 年全球疾病负担研究的死亡率、发病率、生命损失年数、残疾生存年数和残疾调整生命年等主要指标，计算了四个次要指标。进行主成分分析以计算 QoC 指数（QCI），该指数在 0-100 分的范围内评分，得分越高表示 QoC 越好，用于计算 1990 年至 2019 年不同地点、年龄组和性别的 QCI。从 1990 年到 2019 年，心内膜炎的全年龄段发病率估计显著增加，而死亡率没有变化。全球年龄标准化 QCI 为 73.6%，高收入国家高于低收入国家。高收入的北美（82.0%）和亚太地区（81.1%）的 QCI 最高，而东欧（43.3%）的 QCI 最低。全球范围内，30-49 岁和 95 岁以上年龄组的 QCI 最高（91.3%）和最低（71.7%）。在大多数国家，特别是那些社会人口指数较低的国家，女性的 QCI 更好。
这是首次对 QCI 进行全球评估，揭示了当前的趋势，并强调了提高心内膜炎 QoC 的必要性，主要是通过及时发现病例、遵守抗生素预防指南、使用靶向抗生素和先进治疗方法，在非洲地区，并解决某些国家的性别不平等问题。
