Juan Bustamante-Munguira1,2, Carlos-A Mestres3, Pablo Alvarez4, Angels Figuerola-Tejerina5, Rocio Eiros Bachiller6, Esther Gómez-Sánchez2,7, Francisco Javier Alvarez2,8, Salvador Resino2,9, Javier Castrodeza10, Eduardo Tamayo2,7. 1. Department of Cardiac Surgery, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain. 2. BioCritic Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain. 3. Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland. 4. Department of Cardiac Surgery, Hospital Universitario Josep Trueta, Gerona, Spain. 5. Department of Preventive Medicine, Hospital Universitario de La Princesa, Madrid, Spain. 6. Department of Cardiology, Clinica Universidad de Navarra, Pamplona, Spain. 7. Department of Anaesthesiology, Hospital Clínico Universitario, Valladolid, Spain. 8. Department of Pharmacology, University of Valladolid, Valladolid, Spain. 9. Unit of Infection and Immunity, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain. 10. Ministry of Health, Social Services and Equality, Madrid, Spain.
Abstract
OBJECTIVES: Infective endocarditis (IE) is a serious and eventually lethal disease with rising incidence in the past couple of decades. The aim of this study was to evaluate the contemporary epidemiological trends of surgical endocarditis patients, to analyse the clinical outcomes and to study their profile, associated prognostic factors and costs. METHODS: This is a retrospective study of all patients admitted for IE in Spanish hospitals and discharged between 1 January 1997 and 31 December 2014. Data were extracted from the minimum basic data set of the National Surveillance System for Hospital Data in Spain provided by the Spanish Ministry of Health. Hospitalizations, comorbidities, outcomes and costs were analysed. RESULTS: In total, 34 399 patients with IE were included; 15.7% of patients received surgical treatment and 84.3% received medical treatment only. Surgical patients were mostly men (71.9%) and had a lower mean age (59.2 ± 16.08 years) than the medical treatment group (P < 0.0001). Mortality among surgical patients showed a decreasing trend between 1997 (32.0%) and 2014 (22.7%) and increased with age (47.6% in ≥85 years of age). Length of hospital stay and the percentage of patients with organ dysfunction were also higher in this group. The cost of the surgical treatment group was higher and increased since 1997 (15 259.22 euros), remaining stable from 2010 (40 700 euros) (P < 0.0001). CONCLUSIONS: Surgical treatment in IE has trended upwards in Spain during the last 2 decades. Patients are getting older and more frequently experience organ dysfunction. Mortality ratio steadily declined without changes in the length of hospital stay.
OBJECTIVES:Infective endocarditis (IE) is a serious and eventually lethal disease with rising incidence in the past couple of decades. The aim of this study was to evaluate the contemporary epidemiological trends of surgical endocarditispatients, to analyse the clinical outcomes and to study their profile, associated prognostic factors and costs. METHODS: This is a retrospective study of all patients admitted for IE in Spanish hospitals and discharged between 1 January 1997 and 31 December 2014. Data were extracted from the minimum basic data set of the National Surveillance System for Hospital Data in Spain provided by the Spanish Ministry of Health. Hospitalizations, comorbidities, outcomes and costs were analysed. RESULTS: In total, 34 399 patients with IE were included; 15.7% of patients received surgical treatment and 84.3% received medical treatment only. Surgical patients were mostly men (71.9%) and had a lower mean age (59.2 ± 16.08 years) than the medical treatment group (P < 0.0001). Mortality among surgical patients showed a decreasing trend between 1997 (32.0%) and 2014 (22.7%) and increased with age (47.6% in ≥85 years of age). Length of hospital stay and the percentage of patients with organ dysfunction were also higher in this group. The cost of the surgical treatment group was higher and increased since 1997 (15 259.22 euros), remaining stable from 2010 (40 700 euros) (P < 0.0001). CONCLUSIONS: Surgical treatment in IE has trended upwards in Spain during the last 2 decades. Patients are getting older and more frequently experience organ dysfunction. Mortality ratio steadily declined without changes in the length of hospital stay.
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