Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000–2012)

Authors: Juan Ambrosioni, Marta Hernández‐Meneses, Emanuele Durante‐Mangoni, Pierre Tattevin, Lars Olaison, Tomáš Freiberger, John P. Hurley, Margaret M. Hannan, Vivian H. Chu, Bruno Hoen, Asunción Moreno, Guillermo Cuervo, Jaume Llopis, José M. Miró, Liliana Clara, Marisa Sánchez, José Casabé, Claudia Cortés, Francisco Nacinovich, P. Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Javier Altclas, Silvia Kogan, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito E. Papanicolas, Tony M. Korman, Despina Kotsanas, Robyn Dever, Phillip D. Jones, Pam Koneçny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Phillip D. Jones, Suzanne Ryan, Phillip D. Jones, Suzanne Ryan, Phillip D. Jones, Jeffrey J. Post, Porl Reinbott, Suzanne Ryan, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armênio Costa Guimarães, Max Grinberg, Alfredo José Mansur, Rinaldo Focaccia Siciliano, Tânia Mara Varejão Strabelli, Marcelo Luiz Campos Vieira, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Cláudio Querido Fortes, Auristela de Oliveira Ramos, Clara Weksler, G. Ferraiuoli, W. Golebiovski, Cristiane da Cruz Lamas, James A. Karlowsky, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Muñoz García, Mauricio Cereceda, Alberto Fíca, Rodrigo Montagna Mella, Ricardo Fernández, Liliana Franco, Javier González, Astrid Natalia Jaramillo, Bruno Baršić, Suzana Bukovski, Vladimir Krajinović, Ana Pangerčić, Igor Rudež, Josip Vincelj, Tomáš Freiberger, Jiří Pol, Barbora Žaloudíková, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, N. Aissa, Corentine Alauzet, François Alla, Catherine Campagnac, Thanh Doco‐Lecompte, Christine Selton‐Suty, Jean‐Paul Casalta, Pierre‐Edouard Fournier, Gilbert Habib, Didier Raoult, Franck Thuny, François Delahaye, Armelle Delahaye, François Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flécher, C. Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Rémadi, Dan Ruşinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, J. Leroy, Patrick Plésiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Christoph Naber, Carl Neuerburg, S. Athanasia, Ioannis Deliolanis, Helen Giamarellou, Θωμάς Τσαγανός, Efthymia Giannitsioti, Elena Mylona, O. Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Elena Mylona, O. Paniara, Κωνσταντίνος Παπανικολάου, John Pyros, Athanasios Skoutelis, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Maor Wanounou, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Ethan Rubinstein, Jacob Strahilevitz, Emanuele Durante‐Mangoni, Domenico Iossa, Serena Orlando, Maria Paola Ursi, Pia Clara Pafundi, Fabiana D’Amico, Mariano Bernardo, Susanna Cuccurullo, Giovanni Dialetto, Franco Enrico Covino, Sabrina Manduca, Alessandro Della Corte, Marisa De Feo, Marie Françoise Tripodi, Enrico Cecchi, Francesco Giuseppe De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Giampiero Carosi, Silvia Magri, Liana Signorini, Zeina A. Kanafani, Souha S. Kanj, Ahmad Sharif-Yakan, Imran Zainal Abidin, Syahidah Syed Tamin, Eduardo Rivera Martínez, Gabriel Israel Soto Nieto, Jan T. M. van der Meer, Stephen T. Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David Murdoch, Stefan I. Dragulescu, Adina Ionac, Cristian Mornoş, O. M. Butkevich, Н. С. Чипигина, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Jameela Edathodu, Magid Halim, Yee‐Yun Liew, Ru‐San Tan, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller‐Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manel Almela, Juan Ambrosioni, Manuel Azqueta, Merçè Brunet, Pedro Castro, Elisa de Lazzari, Carlos Falces, David Fuster, Guillermina Fita, Cristina Garcia-de-la-Maria, Javier García‐González, José M. Gatell, Jaume Llopis, Francesc Marco, José M. Miró, Asunción Moreno, José Ortíz, Salvador Pié i Ninot, J.C. Paré, Juan M. Pericàs, Eduard Quintana, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Adrián Téllez, José Marı́a Tolosana, Bárbara Vidal, Jordi Vilà, Ignasi Anguera, Bernat Font, Joan Raimón Gumà, Javier Bermejo, Emilio Bouza, Miguel Ángel García Fernández, Victor Gonzalez-Ramallo Mercedes Marín, Patricia Muñóz, Miguel Pedromingo, J. Roda, Marta Rodríguez‐Créixems, Jorge Solı́s, Benito Almirante, Nuria Fernández‐Hidalgo, Pilar Tornos, Arístides de Alarcón, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg‐Martin, Orathai Pachirat, Pimchitra Pachirat, Burabha Pussadhamma, Vichai Senthong, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol A. Kauffman, Roger Bedimo, Vivian H. Chu, G. Ralph Corey, Anna Lisa Crowley, Pamela S. Douglas, Laura Drew, Vance G. Fowler, Thomas L Holland, Tahaniyat Lalani, Daniel W. Mudrick, Zaniab Samad, Daniel J. Sexton, Martín E. Stryjewski, Andrew Wang, Christopher W. Woods, Stamatios Lerakis, Robert Cantey, Lisa L. Steed, Dannah Wray, Stuart A. Dickerman, Hector Bonilla, Joseph R. DiPersio, Sara‐Jane Salstrom, John W. Baddley, Mukesh Patel, Gail Peterson, Amy Stancoven, Donald P. Levine, Jonathan Riddle, Michael J. Rybak, Christopher H. Cabell, Khaula Baloch, Vivian H. Chu, G. Ralph Corey, Christy C. Dixon, Vance G. Fowler, Tina Harding, Marian Jones‐Richmond, Lawrence P. Park, Bob Sanderford, Judy Stafford, Kevin J. Anstrom, Eugene Athan, Arnold S. Bayer, Christopher H. Cabell, Vivian H. Chu, G. Ralph Corey, Vance G. Fowler, Bruno Hoen, Adolf W. Karchmer, José M. Miró, David Murdoch, Daniel J. Sexton, Andrew Wang, Arnold S. Bayer, Christopher H. Cabell, Vivian H. Chu, G. Ralph Corey, David T. Durack, Susannah Eykyn, Vance G. Fowler, Bruno Hoen, José M. Miró, Phillipe Moreillon, Lars Olaison, Didier Raoult, Daniel J. Sexton - Infectious Diseases and Therapy 2023 cited by 75

INTRODUCTION: Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide. METHODS: The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century. RESULTS: IE cases from 13 European countries were included. Two periods were considered: 2000-2006 and 2008-2012. Two European regions were considered, according to the United Nations geoscheme for Europe: Southern (SE) and Northern-Central Europe (NCE). Comparisons were performed between regions and periods. A total of 4195 episodes of IE were included, 2113 from SE and 2082 from NCE; 2787 cases were included between 2000 and 2006 and 1408 between 2008 and 2012. Median (IQR) age was 63.7 (49-74) years and 69.4% were males. Native valve IE (NVE), prosthetic valve IE (PVE), and device-related IE were diagnosed in 68.3%, 23.9%, and 7.8% of cases, respectively; 52% underwent surgery and 19.3% died during hospitalization. NVE was more prevalent in NCE, whereas device-related IE was more frequent in SE. Higher age, acute presentation, hemodialysis, cancer, and diabetes mellitus all were more prevalent in the second period. NVE decreased and PVE and device-related IE both increased in the second period. Surgical treatment also increased from 48.7% to 58.4% (p < 0.01). In-hospital and 6-month mortality rates were comparable between regions and significantly decreased in the second period. CONCLUSIONS: Despite an increased complexity of IE cases, prognosis improved in recent years with a significant decrease in 6-month mortality. Outcome did not differ according to the European region (SE versus NCE).