Mortality trends of infective endocarditis in Spain (2003-2022)

Background

Infective endocarditis (IE) is a life-threatening infection with high morbidity and mortality. Trends in IE-related mortality have been less extensively studied compared to incidence. This study aimed to examine IE mortality trends in Spain from 2003 to 2022.

Methods

This longitudinal ecological study analyzed data from the Spanish National Statistics Institute. Age-standardized mortality rates (ASMRs) were calculated, and joinpoint regression and age-period-cohort (APC) models were used to identify trends and underlying factors.

Results

A total of 25,327 deaths from IE occurred, with a higher number in women. Mortality was strongly age-related, with the vast majority in those over 65. Joinpoint analysis revealed increasing ASMRs in men for all ages and the 65+ age group, while rates remained stable in women. The 35–64 age group showed a decrease in rates for both sexes. A-P-C analysis confirmed age as a significant effect, with mortality rates increasing with age for both sexes. Cohort effects showed a decline in mortality risk in successive birth cohorts, particularly those born after the 1920s and 1930s. Period effects demonstrated a decline in IE mortality risk over the study period.

Conclusion

IE mortality trends in Spain are complex, with significant progress in reducing mortality rates, particularly among younger adults and women. However, challenges remain, especially for older men. These findings highlight the need for targeted interventions and further research to understand the factors driving mortality changes and improve outcomes for all affected by IE.