INFECTIVE ENDOCARDITIS, 1984 THROUGH 1993 - A CLINICAL AND MICROBIOLOGICAL SURVEY

Objectives, To characterize the epidemiology and the clinical and micr obiological spectrum of infective endocarditis in a Danish population. Design, A retrospective review. Setting, All episodes hospitalized of infective endocarditis from 1984 to 1993 in Viborg County were review ed. The county is served by one general and four local hospitals. Subj ects. One hundred and nine episodes of suspected infective endocarditi s with 62 episodes in 59 patients fulfilling the diagnostic criteria b y von Reyn. Results. An overall incidence of 27 episodes per million p er year was found. The incidence was 17.4 episodes per million per yea r in the first part of the decade and 36.5 episodes per million per ye ar in the second part (P < 0.001). Microscopic haematuria was found in 70.2% of the patients with infective endocarditis, compared to 16.7% of the patients in whom the diagnosis was rejected (P < 0.01). Staphyl ococcus aureus was found in 38.9%, non-beta-haemolytic streptococci in 24.1% and Enterococcus faecalis in 16.7%. The overall mortality was 3 5.5%. The mortality decreased significantly from 50.0% in the first pa rt of the decade to 28.6% in the second part (P < 0.01). The mortality was 23.1% in patients in whom the diagnosis was established whilst th ey were alive. This finding was significantly lower than the overall m ortality (P < 0.05). Conclusion, The incidence of infective endocardit is increased during the decade. The frequency of non-beta-haemolytic s treptococci was lower than normally reported. Mortality is still high, with the main mortality within the first week in hospital, which stre sses the importance of early case detection and treatment.