title: Incidence and complication rate of infective endocarditis in the Dutch region of Walcheren: a 3-year retrospective study.
abstract: OBJECTIVE
  To measure the incidence of infective endocarditis (IE) in the region of Walcheren and to estimate the complication and comorbidity rate of IE, we conducted a 3-year retrospective study of IE in the only hospital (Ziekenhuis Walcheren) of the region between January, 2002 and December, 2004.
  
  
  RESULTS
  The total number of cases was 32. The calculated yearly incidence of IE was 9.61 cases per 100.000 inhabitants per year. The median age was 64 years (range 36-81 years). When applying the Duke criteria 28 patients (87.5%) were classified as definite IE and 4 patients (12.5%) as possible IE. Blood cultures were positive in 27 patients (84.4%). The most commonly isolated organisms were streptococci (37.5%). Staphylococcus aureus was isolated in 31.3% of positive blood cultures. Enteroccocus faecalis was identified in 3 cases (9.4%). In only 15.6% of the cases was the course of IE uncomplicated. The most frequent complications were heart failure (59.4%) and embolic events (34.4%). Cardiac surgery was performed in 37.5% of the cases. Concomitant morbidity was found in 75% of the patients. Especially, the high incidences of diabetes mellitus (28.1%), chronic renal failure (28.1%) and chronic obstructive pulmonary disease (21.9%) were remarkable.
  
  
  CONCLUSIONS
  The calculated incidence of IE of 9.61 cases per 100,000 inhabitants per year was more than five times higher than the one reported in a nation-wide Dutch study of 1992. The present study demonstrates that IE remains a disease with a considerable mortality and complication rate. The majority of the patients with IE had non-cardiac comorbidity. Especially, the prevalence of diabetes mellitus and chronic renal failure in our population of patients with IE is remarkable.
authors.affiliation: Department of Cardiology, Ziekenhuis Walcheren, Koudekerkseweg 88, Postbus 3200, 4380 DD Vlissingen, The Netherlands. walpot@zwv.nl
authors.forename: Jeroen
authors.initials: J
authors.lastname: Walpot
authors.forename: Willem
authors.initials: W
authors.lastname: Blok
authors.forename: Jan
authors.initials: J
authors.lastname: van Zwienen
authors.forename: Cees
authors.initials: C
authors.lastname: Klazen
authors.forename: Bram
authors.initials: B
authors.lastname: Amsel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D015897:Comorbidity; D004452:Echocardiography; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology* / Q000601:surgery; D013293:Enterococcus faecalis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000453:epidemiology; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000453:epidemiology*; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology*; D013997:Time Factors