Infective endocarditis: is uncommon, but occurred in iv drug users.

Clinical bottom line (level 2c)

  1. Infective endocarditis was rare.
  2. Many patients who developed infective endocarditis were injecting-drug users.
Berlin et al: American Journal of Cardiology 1995; 76: 933-936
Expires October 2003

The study

Outcome study with blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: 51 hospitals in six metropolitan counties, USA

3200000 patients (aged ?, ?% male) residing in one of six contiguous counties, constituting six of the eight countries in the metropolitan statistical area

Excluded if
  • aged < 18




    • All admitted with suspected infective endocarditis over followed for 27 months
    Outcomes studied:
  • infective endocarditis
  • community native valve
  • prosthetic valve
  • injecting-drug users

    • Patients were defined as definite, probable, or possible cases by three blinded clinicians using von Reyn criteria.

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    infective endocarditis 27 months 670/3200000 0.021%
    (0.020% to 0.023%)    		 4700
    (4400 to 5100)
    community native valve 27 months 257/3200000 0.0080%
    (0.0070% to 0.0090%)    		 12000
    (11000 to 14000)
    prosthetic valve 27 months 54/3200000 0.0017%
    (0.0012% to 0.0021%)    		 59000
    (47000 to 81000)
    injecting-drug users 27 months 308/3200000 0.0096%
    (0.0086% to 0.011%)    		 10000
    (9300 to 12000)

    Citation

    1. Berlin JA, Abrutyn E, Strom BL, et al: incidence of infective endocarditis in the Delaware Valley, 1988-1990. American Journal of Cardiology 1995; 76: 933-936
    Contributor: Chris Ball and Clare Wotton, October 1999
    Reviewer:

    Clinical Question.
    Patient patients in population
    Intervention or Exposure prevalence of
    Outcome infective endocarditis