Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China
Abstract Background The epidemiological and clinical characteristics of infective endocarditis (IE) in mainland China, particularly following the COVID-19 pandemic, remain insufficiently understood. This study aims to examine temporal trends, clinical features, and factors influencing in-hospital mo...
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BMC
2025-03-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04633-8 |
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| author | Jie Liu Jingya Liu Taipu Guo Wei Cong Yunhan Fei Enquan Wang Yuehao Shen Ying Gao Dongxue Huang Yu Meng Hua Shao Dongming Cao Jing Li Keliang Xie |
| author_facet | Jie Liu Jingya Liu Taipu Guo Wei Cong Yunhan Fei Enquan Wang Yuehao Shen Ying Gao Dongxue Huang Yu Meng Hua Shao Dongming Cao Jing Li Keliang Xie |
| author_sort | Jie Liu |
| collection | DOAJ |
| description | Abstract Background The epidemiological and clinical characteristics of infective endocarditis (IE) in mainland China, particularly following the COVID-19 pandemic, remain insufficiently understood. This study aims to examine temporal trends, clinical features, and factors influencing in-hospital mortality of IE in northern China from 2019 to 2023. Methods This multicenter, retrospective study included 961 patients diagnosed with IE between 2019 and 2023 across hospitals in Henan, Shandong, and Tianjin. Data were collected on demographics, comorbidities, COVID-19 status, and treatment modalities. Risk factors for in-hospital mortality were identified using logistic regression and Cox proportional hazards models. The effect of surgical intervention was assessed through propensity score matching. Results In-hospital mortality increased from 7.7% in 2019 to 26.4% in 2023, with an average annual growth of 38% (P = 0.008). The proportion of IE patients aged 65 years and older significantly increased, with this age group exhibiting the highest mortality rate (37.3%) by 2023. Surgical intervention was associated with a 91% reduction in in-hospital mortality (HR 0.09, 95% CI 0.05–0.15, P < 0.001). Independent risk factors for mortality included low left ventricular ejection fraction (LVEF), elevated heart rate (HR), cerebral hemorrhage, the use of vasoactive drugs and the requirement for continuous renal replacement therapy (CRRT). Conclusion In-hospital mortality due to IE in northern China has risen substantially since 2019, particularly in elderly patients and those with comorbid conditions. There was no significant change in overall per capita hospitalization costs or length of stay. Surgical intervention significantly improved survival outcomes. Additionally, patients who have been infected with COVID-19 twice had an 81.3% increased risk of death. The results of this study provide important data into the epidemiological and medical burden of IE in mainland China since the COVID-19 epidemic. |
| format | Article |
| id | doaj-art-18fe0301efe04e0d9c6ce7f2e20c61b7 |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-18fe0301efe04e0d9c6ce7f2e20c61b72025-08-20T02:56:11ZengBMCBMC Cardiovascular Disorders1471-22612025-03-0125111010.1186/s12872-025-04633-8Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in ChinaJie Liu0Jingya Liu1Taipu Guo2Wei Cong3Yunhan Fei4Enquan Wang5Yuehao Shen6Ying Gao7Dongxue Huang8Yu Meng9Hua Shao10Dongming Cao11Jing Li12Keliang Xie13Department of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Emergency, Tianjin Huanhu HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Intensive Care Uint, Liaocheng People’s HospitalShanxi Academy of Medical Sciences, Shanxi Bethune HospitalDepartment of Critical Care Medicine, Tianjin Medical University General HospitalAbstract Background The epidemiological and clinical characteristics of infective endocarditis (IE) in mainland China, particularly following the COVID-19 pandemic, remain insufficiently understood. This study aims to examine temporal trends, clinical features, and factors influencing in-hospital mortality of IE in northern China from 2019 to 2023. Methods This multicenter, retrospective study included 961 patients diagnosed with IE between 2019 and 2023 across hospitals in Henan, Shandong, and Tianjin. Data were collected on demographics, comorbidities, COVID-19 status, and treatment modalities. Risk factors for in-hospital mortality were identified using logistic regression and Cox proportional hazards models. The effect of surgical intervention was assessed through propensity score matching. Results In-hospital mortality increased from 7.7% in 2019 to 26.4% in 2023, with an average annual growth of 38% (P = 0.008). The proportion of IE patients aged 65 years and older significantly increased, with this age group exhibiting the highest mortality rate (37.3%) by 2023. Surgical intervention was associated with a 91% reduction in in-hospital mortality (HR 0.09, 95% CI 0.05–0.15, P < 0.001). Independent risk factors for mortality included low left ventricular ejection fraction (LVEF), elevated heart rate (HR), cerebral hemorrhage, the use of vasoactive drugs and the requirement for continuous renal replacement therapy (CRRT). Conclusion In-hospital mortality due to IE in northern China has risen substantially since 2019, particularly in elderly patients and those with comorbid conditions. There was no significant change in overall per capita hospitalization costs or length of stay. Surgical intervention significantly improved survival outcomes. Additionally, patients who have been infected with COVID-19 twice had an 81.3% increased risk of death. The results of this study provide important data into the epidemiological and medical burden of IE in mainland China since the COVID-19 epidemic.https://doi.org/10.1186/s12872-025-04633-8Infective endocarditisClinical epidemiologyMedical burdenAgingOutcome prediction |
| spellingShingle | Jie Liu Jingya Liu Taipu Guo Wei Cong Yunhan Fei Enquan Wang Yuehao Shen Ying Gao Dongxue Huang Yu Meng Hua Shao Dongming Cao Jing Li Keliang Xie Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China BMC Cardiovascular Disorders Infective endocarditis Clinical epidemiology Medical burden Aging Outcome prediction |
| title | Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China |
| title_full | Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China |
| title_fullStr | Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China |
| title_full_unstemmed | Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China |
| title_short | Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China |
| title_sort | temporal trends clinical characteristics and prognostic factors analysis of infective endocarditis a multicenter ambispective cohort study in china |
| topic | Infective endocarditis Clinical epidemiology Medical burden Aging Outcome prediction |
| url | https://doi.org/10.1186/s12872-025-04633-8 |
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