Abstract
IntroductionInfective endocarditis (IE) presents with increasing incidence and mortality in some regions and countries, as well as serious socioeconomic burden. The current study aims to compare and interpret the IE burden and temporal trends globally and in different regions from 1990 to 2019.MethodsData on the incidence, deaths and disability-adjusted life years (DALYs) caused by IE were extracted and analyzed from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPC) were adopted to quantify the change trends of age-standardized rates (ASRs). Besides, potential contributors of serious IE burden were also evaluated including age, gender, social-demographic index (SDI), and age-standardized incident rate (ASIR) in 1990.ResultsGlobally, the number of IE cases and deaths has increased sharply during the past 30 years from 478,000 in 1990 to 1,090,530 in 2019 and from 28,750 in 1990 to 66,320 in 2019, and both presented an upward temporal trend annually (EAPC:1.2 for incidence and 0.71 for death). However, the EAPC of age-standardized DALYs demonstrated a negative temporal trend despite increasing DALYs from 1,118,120 in 1990 to 1,723,590 in 2019. Moreover, older patients and men were more severely affected. Meanwhile, different SDI regions had different disease burdens, and correlation analyses indicated that SDI presented a positive association with ASIR (R = 0.58, P < 0.0001), no association with age-standardized death rate (R = −0.06, P = 0.10), and a negative association with age-standardized DALYs (R = −0.40, P < 0.0001). In addition, the incidence of IE increased in most countries during the past 30 years (190 out of 204 countries). However, the change trends of deaths and DALYs were heterogeneous across regions and countries. Finally, we discovered positive associations of the EAPC of ASRs with the SDI in 2019 among 204 countries and territories but few associations with the ASIR in 1990.ConclusionGenerally, the global burden of IE is increasing, and there is substantial heterogeneity in different genders, ages and regions, which may help policy-makers and medical staff respond to IE and formulate cost-effective interventional measures.
Highlights
Infective endocarditis (IE) presents with increasing incidence and mortality in some regions and countries, as well as serious socioeconomic burden
In the past 30 years, the incidence of IE in different Social developmental index (SDI) regions rose gradually, and the incidence in males was higher than that in females (Figure 1A, Table 1)
In 1990, the high-middle SDI region had the most age-standardized incident rate (ASIR) (11.34 per 100,000 population [95% certainty interval (CI): 9.44–13.59]), the middle SDI region had the most incidence cases (159,200 [95% CI: 130,200–191,000]), while the incidence case or ASIR of the low SDI region was the lowest (30,590 [95% CI: 24,430–38,070]; 6.29 [95% CI: 5.23–7.50])
Summary
Infective endocarditis (IE) presents with increasing incidence and mortality in some regions and countries, as well as serious socioeconomic burden. The current study aims to compare and interpret the IE burden and temporal trends globally and in different regions from 1990 to 2019. Infective endocarditis (IE) is a life-threatening cardiac infection and is predisposed to occur in some individuals with multiple cardiac valve conditions [1], with an annual incidence of ∼3– 10 per 100,000 people [2]. IE remains a highly lethal disease, with the overall mortality remaining at ∼25% [2, 3]. A population-based survey in France suggested that the age-standardized and sex-standardized annual incidence of IE was 33.8 cases per million inhabitants and the overall inhospital mortality rate was 22.7% [4]. Increased efforts to reduce the burden of IE seem logical and needed [7]
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