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oai:repisalud.isciii.es:20.500.12105/88902025-04-30T11:31:11Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19609

00925njm 22002777a 4500 dc Ortega-Loubon, Christian author Muñoz-Moreno, Maria Fe author García, Irene Andrés author Álvarez, Francisco Javier author Gómez-Sánchez, Esther author Bustamante-Munguira, Juan author Lorenzo-López, Mario author Tamayo-Velasco, Álvaro author Jorge-Monjas, Pablo author Resino, Salvador author Tamayo, Eduardo author Heredia-Rodríguez, María author 2019-10-22 Major changes have occurred in the epidemiology and etiology of infective endocarditis (IE). Nevertheless, the differences between nosocomial infective endocarditis (NIE) and community-acquired infective endocarditis (CIE) have not been addressed in a population-based study. We conducted a retrospective, nationwide, temporal trend study from 1997 to 2014 analyzing the epidemiology, clinical, geographical, meteorological characteristics of patients diagnosed with IE in Spain, to distinguish NIE from CIE. Among 25,952 patients with IE (62.2 ± 18·6 years; 65.9% men), 45.9% had NIE. The incidence of IE increased from 2.83 to 3.73 due to the NIE incidence increment with a decline in CIE. Patients with NIE were older (63.8 years vs. 60.8 years, p < 0·001), presented a higher Charlson index (1.22 vs. 1.03, p < 0.001), a greater history of implanted cardiac devices (8.7% vs. 4.6%, p < 0.001), and higher mortality (31.5% vs. 21.7%, p < 0.001). The most frequent microorganism for both NIE and CIE was Staphylococcus (p < 0.001), and the North reported a higher incidence (p < 0.001). Risk factors of mortality for NIE were age, Charlson index, hemodialysis, shock, heart failure, and stroke. Risk factors for CIE included female sex, renal disease, and cardiac-device carriers. The etiology of IE shifted from community origins to mostly nosocomial-associated infections. Higher morbidity, mortality, and poorer outcomes are associated with NIE. J Clin Med. 2019 Oct 22;8(10). pii: E1755. 10.3390/jcm8101755 2077-0383 Journal of clinical medicine 31652613 http://hdl.handle.net/20.500.12105/8890 Community-acquired Infective endocarditis Location Mortality Nosocomial Nosocomial Vs. Community-Acquired Infective Endocarditis in Spain: Location, Trends, Clinical Presentation, Etiology, and Survival in the 21st Century