title: Epidemiologic features of infective endocarditis in Taiwanese adults involving native valves.
abstract: Little is known about the incidence and clinical outcomes of infective endocarditis (IE) involving native valves in Asian countries. This nationwide study investigated epidemiologic features and in-hospital mortality associated with IE in adults (age > or =18 years) based on Taiwan's National Health Insurance database from 1997 through 2002. Of 7,240 enrolled patients with IE involving native valves, the mean age was 53 +/- 19 years and 70% were men. The mean annual crude incidence was 7.6 per 100,000 inhabitants. The incidence was significantly higher in men than in women (10.4 vs 4.6 per 100,000; p <0.001). The incidence of IE increased steadily with age, ranging from 3.8 per 100,000 persons in patients <30 years of age to 33 per 100,000 persons in patients > or =80 years of age (p <0.001). Staphylococcal (32%) and streptococcal species (61%) were the most common causative pathogens. The mean in-hospital mortality rate was 18%. Multivariate analysis showed that male gender, older age (> or =50 years), diabetes mellitus, heart failure, neurologic complications, renal insufficiency, respiratory failure, shock, and Staphylococcus species as the causative microorganism were independent predictors of in-hospital mortality. In conclusion, this Taiwanese study revealed a high incidence of IE in men and elderly subjects. The in-hospital mortality rate remained high. Patients with IE who also developed shock and respiratory failure were the most likely to have a poor outcome.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Lee
authors.forename: Wei-Chuan
authors.initials: WC
authors.lastname: Tsai
authors.forename: Ping-Yen
authors.initials: PY
authors.lastname: Liu
authors.forename: Liang-Miin
authors.initials: LM
authors.lastname: Tsai
authors.forename: Ming-Tsung
authors.initials: MT
authors.lastname: Ho
authors.forename: Jyh-Hong
authors.initials: JH
authors.lastname: Chen
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D016208:Databases, Factual; D004697:Endocarditis, Bacterial / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D013290:Streptococcal Infections / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D013624:Taiwan / Q000453:epidemiology