Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000-2012). 二十一世纪欧洲感染性心内膜炎的流行病学变化及改善：国际心内膜炎协作研究（ICE）前瞻性队列研究（2000-2012）。
Epidemiological Changes and Improvement in Outcomes of Infective Endocarditis in Europe in the Twenty-First Century: An International Collaboration on Endocarditis (ICE) Prospective Cohort Study (2000-2012).
发表日期：2023 Mar 15
作者：
Juan Ambrosioni, Marta Hernández-Meneses, Emanuele Durante-Mangoni, Pierre Tattevin, Lars Olaison, Tomas Freiberger, John Hurley, Margaret M Hannan, Vivian Chu, Bruno Hoen, Asunción Moreno, Guillermo Cuervo, Jaume Llopis, José M Miró,
来源：
TROPICAL MEDICINE & INTERNATIONAL HEALTH
摘要：
感染性心内膜炎在全球流行病学方面已经发生了重大变化。该研究旨在根据预定的欧洲地区和21世纪的两个不同时间段比较IE的流行病学特征和结果。研究包括了13个欧洲国家的IE病例。考虑了两个时期：2000-2006和2008-2012年。根据联合国欧洲地理方案，考虑了两个欧洲地区：南欧洲（SE）和中北欧（NCE）。对地区和时期进行了比较。总共包括了4195个IE发作，2113个来自SE，2082个来自NCE；2000年至2006年间包括2787例，2008年至2012年间包括1408例。中位数（IQR）年龄为63.7（49-74）岁，69.4%为男性。在病例中，原发性心瓣膜感染（NVE）、人工瓣膜感染（PVE）和器械相关性感染分别占68.3%、23.9%和7.8%；52%接受了手术治疗，在住院期间有19.3%死亡。在NCE中NVE更为普遍，而在SE中器械相关感染更为频繁。第二个时期更年长、急性表现、血液透析、癌症和糖尿病都更为普遍。第二个时期NVE减少，而PVE和器械相关感染都增加了。手术治疗也从48.7%增加到58.4%（P<0.01）。在医院内和6个月的死亡率在地区之间是可比较的，并在第二个时期显著下降。尽管IE病例的复杂性增加了，但近年来预后有所改善，6个月的死亡率显著降低。结果根据欧洲地区（SE与NCE）并没有不同。©2023年，作者。
Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide.The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century.IE cases from 13 European countries were included. Two periods were considered: 2000-2006 and 2008-2012. Two European regions were considered, according to the United Nations geoscheme for Europe: Southern (SE) and Northern-Central Europe (NCE). Comparisons were performed between regions and periods. A total of 4195 episodes of IE were included, 2113 from SE and 2082 from NCE; 2787 cases were included between 2000 and 2006 and 1408 between 2008 and 2012. Median (IQR) age was 63.7 (49-74) years and 69.4% were males. Native valve IE (NVE), prosthetic valve IE (PVE), and device-related IE were diagnosed in 68.3%, 23.9%, and 7.8% of cases, respectively; 52% underwent surgery and 19.3% died during hospitalization. NVE was more prevalent in NCE, whereas device-related IE was more frequent in SE. Higher age, acute presentation, hemodialysis, cancer, and diabetes mellitus all were more prevalent in the second period. NVE decreased and PVE and device-related IE both increased in the second period. Surgical treatment also increased from 48.7% to 58.4% (p < 0.01). In-hospital and 6-month mortality rates were comparable between regions and significantly decreased in the second period.Despite an increased complexity of IE cases, prognosis improved in recent years with a significant decrease in 6-month mortality. Outcome did not differ according to the European region (SE versus NCE).© 2023. The Author(s).