Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN

Daniel C. Desimone, Imad M. Tleyjeh, Daniel D. Correa De Sa, Nandan S. Anavekar, Brian D. Lahr, Muhammad R. Sohail, James M. Steckelberg, Walter R. Wilson, Larry M. Baddour

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Abstract

Background The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted. Methods This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013. Results We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P =.222) but was significantly higher in males and those of older age (P <.001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester. Conclusion In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.

Original languageEnglish (US)
Pages (from-to)830-836
Number of pages7
JournalAmerican Heart Journal
Volume170
Issue number4
DOIs
StatePublished - Oct 1 2015

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Endocarditis
Epidemiology
Incidence
Population
Viridans Streptococci
Coagulase
Enterococcus
Staphylococcus
Tertiary Care Centers
Staphylococcus aureus
Referral and Consultation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Desimone, D. C., Tleyjeh, I. M., Correa De Sa, D. D., Anavekar, N. S., Lahr, B. D., Sohail, M. R., ... Baddour, L. M. (2015). Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. American Heart Journal, 170(4), 830-836. https://doi.org/10.1016/j.ahj.2015.07.007

Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. / Desimone, Daniel C.; Tleyjeh, Imad M.; Correa De Sa, Daniel D.; Anavekar, Nandan S.; Lahr, Brian D.; Sohail, Muhammad R.; Steckelberg, James M.; Wilson, Walter R.; Baddour, Larry M.

In: American Heart Journal, Vol. 170, No. 4, 01.10.2015, p. 830-836.

Research output: Contribution to journalArticle

Desimone, DC, Tleyjeh, IM, Correa De Sa, DD, Anavekar, NS, Lahr, BD, Sohail, MR, Steckelberg, JM, Wilson, WR & Baddour, LM 2015, 'Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN', American Heart Journal, vol. 170, no. 4, pp. 830-836. https://doi.org/10.1016/j.ahj.2015.07.007
Desimone DC, Tleyjeh IM, Correa De Sa DD, Anavekar NS, Lahr BD, Sohail MR et al. Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. American Heart Journal. 2015 Oct 1;170(4):830-836. https://doi.org/10.1016/j.ahj.2015.07.007
Desimone, Daniel C. ; Tleyjeh, Imad M. ; Correa De Sa, Daniel D. ; Anavekar, Nandan S. ; Lahr, Brian D. ; Sohail, Muhammad R. ; Steckelberg, James M. ; Wilson, Walter R. ; Baddour, Larry M. / Temporal trends in infective endocarditis epidemiology from 2007 to 2013 in Olmsted County, MN. In: American Heart Journal. 2015 ; Vol. 170, No. 4. pp. 830-836.
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abstract = "Background The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted. Methods This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013. Results We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41{\%} were females. Age- and sex-adjusted incidence of IE was 7.4 (95{\%} CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P =.222) but was significantly higher in males and those of older age (P <.001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6{\%} (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4{\%} (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester. Conclusion In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.",
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AU - Anavekar, Nandan S.

AU - Lahr, Brian D.

AU - Sohail, Muhammad R.

AU - Steckelberg, James M.

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N2 - Background The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted. Methods This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013. Results We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P =.222) but was significantly higher in males and those of older age (P <.001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester. Conclusion In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.

AB - Background The aim of this study is to determine if there have been contemporary shifts in infective endocarditis (IE) epidemiology in our local population; an analysis of cases from 2007 to 2013 was conducted. Methods This is a population-based review of all adults (≥18 years) residing in Olmsted County, MN, with definite or possible IE using the Rochester Epidemiology Project from January 1, 2007, to December 31, 2013. Results We identified 51 cases of IE in Olmsted County, MN, between 2007 and 2013. Median age of IE cases was 68.8 years (interquartile range 55.6-76.5), and 41% were females. Age- and sex-adjusted incidence of IE was 7.4 (95% CI 5.3-9.4) cases per 100,000 person-years. From a multivariable Poisson regression model, incidence of IE did not change significantly during the study period (P =.222) but was significantly higher in males and those of older age (P <.001). The annual incidences (per 100,000 person-years) were 2.5 for Staphylococcus aureus, 1.1 for viridans group streptococci, 1.6 for Enterococcus species, and 0.8 for coagulase-negative staphylococci. Only 19.6% (10/51) of Olmsted County patients underwent valve surgery between 2007 and 2013 as compared with 44.4% (197/444) of non-Olmsted County patients treated at Mayo Clinic Rochester. Conclusion In this population-based study, no significant change in the overall incidence of IE in Olmsted County, MN, between 2007 and 2013 was seen, and it was similar to that seen between 1970 and 2006. Male gender and older age were associated with increased IE risk. With a lesser extent of cases attributable to viridans group streptococcal IE compared with previous years, S aureus was the predominant pathogen in IE cases during 2007 to 2013. The relatively low valve surgery rate was disparate from that reported from large, tertiary care centers (including our own) with non-population-based cohorts, which are subject to referral bias and can influence the expected characterization of IE.

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