RISK OF INFECTIVE ENDOCARDITIS IN TAIWAN: RETROSPECTIVE COHORT STUDY

Yueh-Chin Chung, PhD*

ABSTRACT

Background: The incidence rate of infective endocarditis (IE) in Taiwan is high. Thus, we investigated the incidence and risk factors of IE among Taiwanese patients. Objective: In this retrospective cohort study, IE cases from 1998 to 2010 were identified from the National Health Insurance Research Database through the International Classification of Diseases, Ninth Revision, Clinical Modification. Poisson regression models were used to assess the relative risks (RRs) and 95% confidence intervals (CIs) of IE associated with sex, age, and odds ratios (ORs) of comorbidities. Among 16,924 patients with IE, 108,22 (51.60%) were male and 6,102 (48.40%) were female. Results: A total of 59.29% patients were older than 50 years. The annual crude incidence was 4.34–6.86 per 100,000 person-years. Our data also demonstrated that the highest incidence rate was on people aged 70–79 years. The incidence rate of IE was higher in males than in females in the 40- to 49-year-old group (RR = 3.12; 95% CI, 2.84–3.43). Staphylococcal (61.38%) and Streptococcal species (28.44%) were the most common causative pathogens. Males showed more statistically significant comorbidities of hypertension (OR = 5.58; 95% CI, 4.32–7.20), disease of aortic valve (OR = 5.01; 95% CI, 4.13–6.08), acute respiratory failure (OR = 9.23; 95% CI ,7.23–11.78), and drug abuse (OR = 6.39; 95% CI, 3.37–12.13) (p < 0.0001) than females. Conclusions: The Taiwanese study revealed a high incidence of IE in men and elderly subjects. Staphylococcal species and cardiovascular and infective valve prevention strategies may help reduce the risk of IE.

Keywords: infective endocarditis, incidence, relative risks, age distribution, prospective cohort study.