Infective endocarditis: epidemiology and mortality
THE CONTEXT
Infective endocarditis affects many older patients and can occur without a recognised pre-existing cardiac abnormality.
Disease burden and age
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The incidence is around 14 cases per 100000 people annually, accounting for more than 66000 deaths worldwide.
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More than 50% of patients are over 60 years old.
Underlying cardiac conditions
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In a large British study, rheumatic heart disease was present in 24%, congenital heart disease in 19%, and other cardiac abnormalities in 25%. Examples of other abnormalities included a calcified aortic valve or floppy mitral valve.
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The remaining 32% were not thought to have a pre-existing cardiac abnormality.
Prognosis
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Bacterial endocarditis has an approximate case fatality of 20% even with treatment.
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Case fatality is higher with prosthetic valve endocarditis and infection caused by antibiotic-resistant organisms.