Lisi Matteo, Flamigni Filippo, Russo Michele, Cameli Matteo, Mandoli Giulia Elena, Pastore Maria Concetta, Mele Donato, Campo Gianluca, Henein Michael Y, Rubboli Andrea
Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena.
Department of Cardiovascular Disease - AUSL Romagna, Division of Cardiology, Ravenna.
J Cardiovasc Med (Hagerstown). 2023 Feb 1;24(2):105-112. doi: 10.2459/JCM.0000000000001410. Epub 2022 Dec 22.
Infective endocarditis (IE) is a significant disease characterized by high mortality and complications. The aim of this study was to evaluate the incidence/100 000 inhabitants and the in-hospital mortality/100 000 inhabitants of IE during the last 10 years in the province of Ravenna.
We reviewed the public hospitals discharge database from January 2010 to December 2020 using the international classification of disease codification (ICD-9) for IE. We used the Italian national statistical institute (ISTAT) archive to estimate the number of Ravenna inhabitants/year. In 10 years, we identified a total of 407 patients with diagnosis of IE.The incidence of IE increased significantly from 6.29 cases/100 000 inhabitants in 2010 to 19.58 cases/100 000 inhabitants in 2020 ( P < 0.001). Also, the in-hospital mortality from IE increased over the same number of years, from 1.8 deaths/100 000 inhabitants in 2010 to 4.4 deaths/100 000 inhabitants in 2020 ( P < 0.001). The mortality rate (%) of IE over the years did not increase ( P = 0.565). Also, over the years there was no difference in the site of infection ( P = 0.372), irrespective of the valve localization or type, native valve ( P = 0.347) or prosthetic valve ( P = 0.145). On logistic regression analysis, age was the only predictor of in-hospital mortality (odds ratio 1.045, 95% confidence interval: 1.015; 1.075, P = 0.003).
Ravenna-based data on IE showed increased disease incidence but unchanged mortality rate over 10 years of follow-up. Age remains the sole predictor of population-based mortality, irrespective of the nature of the valve, native or substitute, and the organism detected on microbiology.
感染性心内膜炎（IE）是一种严重疾病，具有高死亡率和并发症。本研究的目的是评估拉文纳省过去10年中IE的发病率/10万居民以及住院死亡率/10万居民。
我们使用IE的国际疾病分类编码（ICD-9），回顾了2010年1月至2020年12月公立医院出院数据库。我们使用意大利国家统计局（ISTAT）档案估计拉文纳每年的居民数量。在10年中，我们共确定了407例诊断为IE的患者。IE的发病率从2010年的6.29例/10万居民显著增加到2020年的19.58例/10万居民（P<0.001）。同样，IE的住院死亡率在相同年份中也有所增加，从2010年的1.8例/10万居民增加到2020年的4.4例/10万居民（P<0.001）。多年来IE的死亡率（%）没有增加（P=0.565）。此外，多年来感染部位没有差异（P=0.372），无论瓣膜定位或类型如何，天然瓣膜（P=0.347）或人工瓣膜（P=0.145）。在逻辑回归分析中，年龄是住院死亡率的唯一预测因素（优势比1.045，95%置信区间：1.015；1.075，P=0.003）。
基于拉文纳的IE数据显示，在10年的随访中疾病发病率增加，但死亡率不变。年龄仍然是基于人群死亡率的唯一预测因素，无论瓣膜的性质是天然的还是替代的，以及微生物学检测到的病原体。
