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感染性心内膜炎的流行病学、临床特征及转归趋势:韩国一项为期16年的全国性队列研究

Trends in Epidemiology, Clinical Characteristics, and Outcomes of Infective Endocarditis: A 16-Year Nationwide Cohort Study in Korea.

作者信息

Ha Kyung Eun, Kim William D, Ko Kyu-Yong, Kim Hasung, Gwak Seo-Yeon, Kim Kyu, Lee Hyun-Jung, Shim Chi Young, Hong Geu-Ru, Ha Jong-Won, Hwang Ji-Won, Cho Iksung

机构信息

Division of Cardiology, Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea.

Chung-Ang University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2025 Aug 11;40(31):e183. doi: 10.3346/jkms.2025.40.e183.

Abstract

BACKGROUND

Infective endocarditis (IE) is a life-threatening disease, the profile of which varies across countries. This nationwide cohort study aimed to assess the epidemiology, clinical characteristics, and outcomes of IE.

METHODS

Patients diagnosed with IE between 2003 and 2018 were included in this study based on data from the National Health Insurance System of South Korea. The patients' baseline characteristics, treatment modalities, and survival outcomes were analyzed. The incidence and in-hospital mortality rates were calculated and adjusted for age.

RESULTS

A total of 8,487 IE cases were included: 6,617 (78.0%), 1,678 (19.8%), and 192 (2.3%) cases of native valve IE, prosthetic valve IE, and cardiac device-related IE (CDRIE), respectively. The incidence rate (per 1,000,000) of IE increased from 7.24 in 2003 to 17.47 in 2018. Furthermore, the in-hospital mortality rate for IE (per 1,000,000 person-years) increased from 0.59 in 2003 to 2.76 in 2018. The proportions of prosthetic valve IE and CDRIE cases increased over time, whereas that of native valve IE cases decreased. The number of surgeries for IE showed a consistent upward trend, with a notable increase occurring from 2014 onward.

CONCLUSION

IE is a health burden with an increasing incidence and high mortality rates. Understanding the epidemiology and characteristics of IE is crucial to establish future treatment strategies.

摘要

背景

感染性心内膜炎(IE)是一种危及生命的疾病,其特征在不同国家有所不同。这项全国性队列研究旨在评估IE的流行病学、临床特征和结局。

方法

基于韩国国民健康保险系统的数据,纳入2003年至2018年间诊断为IE的患者。分析患者的基线特征、治疗方式和生存结局。计算发病率和住院死亡率,并对年龄进行调整。

结果

共纳入8487例IE病例:分别为6617例(78.0%)原发性瓣膜心内膜炎、1678例(19.8%)人工瓣膜心内膜炎和192例(2.3%)心脏装置相关感染性心内膜炎(CDRIE)。IE的发病率(每100万人)从2003年的7.24增加到2018年的17.47。此外,IE的住院死亡率(每100万人年)从2003年的0.59增加到2018年的2.76。人工瓣膜心内膜炎和CDRIE病例的比例随时间增加,而原发性瓣膜心内膜炎病例的比例下降。IE手术数量呈持续上升趋势,从2014年起显著增加。

结论

IE是一种健康负担,发病率不断上升且死亡率高。了解IE的流行病学和特征对于制定未来治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a71/12339901/9d64aed56bb5/jkms-40-e183-g001.jpg

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