Epidemiology of infective endocarditis in a large Belgian non-referral hospital

Abstract

Objectives:

Guidelines for diagnosis of infective endocarditis are largely based upon epidemiological studies in referral hospitals. Referral bias, however, might impair the validity of guidelines in non-referral hospitals. Recent studies in non-referral care centres on infective endocarditis are sparse. We conducted a retrospective epidemiological study on infective endocarditis in a large non-referral hospital in a Belgian city (Kortrijk).

Methods:

The medical record system was searched for all cases tagged with a putative diagnosis of infective endocarditis in the period 2003–2010. The cases that fulfilled the modified Duke criteria for probable or definite infective endocarditis were included.

Results:

Compared to referral centres, an older population with infective endocarditis, and fewer predisposing cardiac factors and catheter-related infective endocarditis is seen in our population. Our patients have fewer prosthetic valve endocarditis as well as fewer staphylococcal endocarditis. Our patients undergo less surgery, although mortality rate seems to be highly comparable with referral centres, with nosocomial infective endocarditis as an independent predictor of mortality.

Conclusion:

The present study suggests that characteristics of infective endocarditis as well as associative factors might differ among non-referral hospitals and referral hospitals.

Keywords:

• Infective endocarditis
• Epidemiology
• Referral bias
• Community hospital

Acknowledgements

The authors wish to thank P. Garré (AZ Groeninge, Kortrijk), Dr H. De Beenhouwer (OLV Hospital Aalst), Dr S. Steyaert (Maria Middelares Hospital Ghent), Professor Dr J. Verhaegen, Dr Meurisse and Professor Dr P. Herijgers (UZ Leuven, University of Leuven), and Prof. Dr D. Vogelaers (UZ Ghent, University of Ghent) for providing us with valuable information.

The authors declare to have no conflicts of interest.