Annales de cardiologie et d'angeiologie · 2026
[Endocarras Registry: Incidence, profile and mortality of infective endocarditis from 2013 to 2024 in a French hospital without on-site cardiac surgery].
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Taleb I, Dozier A, Raddaoui H, Hembert K, Sghaier A, Mainil S, Favata F, Fleuriet J, Seunes C, Ouadah A, Le Goffic C, Meghnem M, Verhaeghe M, Le Tadic P, Cardot J, Diharce C, Velain L, Dangbegnon M, Bearez E, Randriamora M, Hannebicque G
Аннотация
INTRODUCTION: Despite improvements in diagnostic and therapeutic strategies, infective endocarditis (IE) remains a life-threatening disease with high in-hospital mortality. However, most contemporary data originate from tertiary referral centres with on-site cardiac surgery. The recruitment bias may lead to an underestimation of the true morbidity and mortality of IE in general hospitals.
OBJECTIVE: The ENDOCARRAS register aimed to determine the epidemiological characteristics and prognosis of patients with IE admitted to the Arras hospital center, French care facility with 1600 beds including a cardiology and intensive care service without on-site cardiac surgery.
METHOD: From January 1st, 2003, to December 31st, 2024, all pts with a definite or possible diagnosis of IE according to modified Duke criteria (applicable at the time of admission) were included. Demographic characteristics, comorbidities, microbiology, imaging modalities, therapeutic strategies, and quality-of-care indicators were collected. Primary endpoints were in-hospital and one-year all-cause mortality. Multivariable logistic regression analyses were performed to identify independent predictors of in-hospital death.
RESULTS: Three hundred and six pts were included. The mean age was 71±13 years, and 59.5% were male. IE was definite in 75% of cases, involving native valves (68.3%), prosthetic valves (20.6%), or intracardiac devices (12.7%). The most frequently identified pathogens were aureus Staphylococci (40.2%), oral streptococci (13%), and enterococci (12.7%). Transoesophagal echocardiography, positron-emission tomography and cardiac CT were performed respectively in 74%, 36.4%, and 4.6% of points. Embolic events occurred in 46.7% of points. Comorbidities included heart failure (36.6%), chronic kidney disease stage 4/5 (19.3%), and bedridden status (17.6%). Cardiac surgery was performed in only 22.9% of pts and contraindicated in 34%. In-hospital and 1-year mortality rates were 27.8 and 40%, respectively. In hospital mortality rise dramatically to 41.5% in patients older than 75 years, compared to 18.6% in younger patients (P<0.001). Age>75 years and the absence of advanced cardiac imaging independently predicted mortality. Over time, IE incidence increased while surgical rates declined.
CONCLUSION: In this real-world monocentric registry spanning 11 years, IE appears increasingly frequent, with persistently high in-hospital mortality and low utilization of cardiac surgery, particularly among older points with severe comorbidities.
OBJECTIVE: The ENDOCARRAS register aimed to determine the epidemiological characteristics and prognosis of patients with IE admitted to the Arras hospital center, French care facility with 1600 beds including a cardiology and intensive care service without on-site cardiac surgery.
METHOD: From January 1st, 2003, to December 31st, 2024, all pts with a definite or possible diagnosis of IE according to modified Duke criteria (applicable at the time of admission) were included. Demographic characteristics, comorbidities, microbiology, imaging modalities, therapeutic strategies, and quality-of-care indicators were collected. Primary endpoints were in-hospital and one-year all-cause mortality. Multivariable logistic regression analyses were performed to identify independent predictors of in-hospital death.
RESULTS: Three hundred and six pts were included. The mean age was 71±13 years, and 59.5% were male. IE was definite in 75% of cases, involving native valves (68.3%), prosthetic valves (20.6%), or intracardiac devices (12.7%). The most frequently identified pathogens were aureus Staphylococci (40.2%), oral streptococci (13%), and enterococci (12.7%). Transoesophagal echocardiography, positron-emission tomography and cardiac CT were performed respectively in 74%, 36.4%, and 4.6% of points. Embolic events occurred in 46.7% of points. Comorbidities included heart failure (36.6%), chronic kidney disease stage 4/5 (19.3%), and bedridden status (17.6%). Cardiac surgery was performed in only 22.9% of pts and contraindicated in 34%. In-hospital and 1-year mortality rates were 27.8 and 40%, respectively. In hospital mortality rise dramatically to 41.5% in patients older than 75 years, compared to 18.6% in younger patients (P<0.001). Age>75 years and the absence of advanced cardiac imaging independently predicted mortality. Over time, IE incidence increased while surgical rates declined.
CONCLUSION: In this real-world monocentric registry spanning 11 years, IE appears increasingly frequent, with persistently high in-hospital mortality and low utilization of cardiac surgery, particularly among older points with severe comorbidities.