Bai Qiyuan, Chen Hao, Liu Hongxu, Li Xuhua, Chen Yang, Guo Dan, Song Bing, Yu Cuntao
The First Clinical Medical College of Lanzhou University, 730000 Lanzhou, Gansu, China.
Department of Cardiovascular Surgery, First Hospital of Lanzhou University, 730013 Lanzhou, Gansu, China.
Rev Cardiovasc Med. 2025 May 20;26(5):27168. doi: 10.31083/RCM27168. eCollection 2025 May.
Endocarditis can lead to health loss and even death, making it one of the major contributors to the global disease burden, with its incidence continuously increasing. This study aimed to assess the trends and frontier analysis of the worldwide burden of endocarditis over the past 30 years and to improve the predictions of its future burden by 2035.
We analyzed the trends of global endocarditis incidence, prevalence, deaths, and disability-adjusted life years (DALYs) at international, regional, and national levels from 1990 to 2021 using a comprehensive, localized, and multidimensional approach. Clustering analysis assessed the changing patterns of disease burden related to endocarditis in the Global Burden of Disease (GBD) study regions. Correlation analysis was conducted to determine the potential relationships between the burden of endocarditis and the socio-demographic index (SDI) and the Human Development Index (HDI). Frontier analysis was performed to identify possible areas for improvement and the disparities in development status among countries. Additionally, we projected the changes in the burden of endocarditis by 2035.
From a global perspective, between 1990 and 2021, the incidence, prevalence, mortality, and DALYs associated with endocarditis have shown a continuous upward trend. At the national level, significant differences were observed in the incidence, prevalence, mortality, and DALYs of endocarditis worldwide. The United States had the highest number of deaths; India had the highest number of DALYs; Thailand had the highest incidence; Sri Lanka had the highest prevalence. The age-standardized rates (ASRs) for endocarditis prevalence, incidence, mortality, and DALYs increased steadily with age, peaking in the 95-year-old and above age group. The incidence, prevalence, mortality, and DALYs for males were 1.27 times, 1.02 times, 1.06 times, and 1.37 times those of females, respectively. Clustering analysis results indicated a significant increase in the estimated annual percentage change (EAPC) of mortality and DALY rates for endocarditis in East Asia. A significant correlation exists between EAPC and the ASRs of disease burden. Frontier analysis showed that countries and regions with higher SDIs have greater potential for improving the disease burden. The Bayesian age-period-cohort (BAPC) results indicated that the incidence, prevalence, mortality, and DALYs case numbers are expected to increase, with the ASRs for incidence and prevalence also projected to show a continuous upward trend by 2035.
The global burden of endocarditis, a significant public health issue, has shown an overall upward trend from 1990 to 2021. The continuous increase in the prevalence and incidence of endocarditis, driven by population growth and aging, has become a major challenge for its control and management, which may guide better public health policy formulation and the rational allocation of medical resources. This targeted approach is crucial for effectively alleviating the burden of this disease.
心内膜炎可导致健康受损甚至死亡，成为全球疾病负担的主要促成因素之一，且其发病率持续上升。本研究旨在评估过去30年全球心内膜炎负担的趋势及前沿分析，并改进对其到2035年未来负担的预测。
我们采用全面、本地化和多维度的方法，分析了1990年至2021年国际、区域和国家层面全球心内膜炎发病率、患病率、死亡数和伤残调整生命年（DALYs）的趋势。聚类分析评估了全球疾病负担（GBD）研究区域内心内膜炎相关疾病负担的变化模式。进行相关性分析以确定心内膜炎负担与社会人口指数（SDI）和人类发展指数（HDI）之间的潜在关系。进行前沿分析以确定可能的改进领域以及各国发展状况的差异。此外，我们预测了到2035年心内膜炎负担的变化。
从全球角度来看，1990年至2021年间，与心内膜炎相关的发病率、患病率、死亡率和DALYs呈持续上升趋势。在国家层面，全球心内膜炎的发病率、患病率、死亡率和DALYs存在显著差异。美国死亡人数最多；印度DALYs数最多；泰国发病率最高；斯里兰卡患病率最高。心内膜炎患病率、发病率、死亡率和DALYs的年龄标准化率（ASRs）随年龄稳步上升，在95岁及以上年龄组达到峰值。男性的心内膜炎发病率、患病率、死亡率和DALYs分别是女性的1.27倍、1.02倍、1.06倍和1.37倍。聚类分析结果表明，东亚心内膜炎死亡率和DALY率的估计年百分比变化（EAPC）显著增加。EAPC与疾病负担的ASRs之间存在显著相关性。前沿分析表明，SDI较高的国家和地区在改善疾病负担方面具有更大潜力。贝叶斯年龄-时期-队列（BAPC）结果表明，发病率、患病率、死亡率和DALYs病例数预计将增加，到2035年发病率和患病率的ASRs也预计将呈持续上升趋势。
心内膜炎的全球负担是一个重大的公共卫生问题，在1990年至2021年间总体呈上升趋势。受人口增长和老龄化驱动，心内膜炎患病率和发病率的持续上升已成为其控制和管理的重大挑战，这可能有助于更好地制定公共卫生政策和合理分配医疗资源。这种有针对性的方法对于有效减轻该疾病的负担至关重要。
