The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019

Abstract Introduction: Infective endocarditis (IE) causes in-mounting incidence and mortality, as well as serious socioeconomic burden in different regions and countries. To compare and interpret the IE burden and temporal trends in the globe and different regions, we conducted this study to report the incidence, death, and disability-adjusted life years (DALYs) from 1990 to 2019. Methods: Data of incidences, deaths and DALYs were extracted and analyzed from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPC) were adopted to quantify the change trends of age-standardized rates (ASRs). Besides, potential contributors of serious IE burden were also evaluated including age, gender, social-demographic index (SDI), and ASIR in 1990.Results: In the globe, the number of IE cases increased by 128% from 478,000 in 1990 to 1,090,530 in 2019, and the deaths increased sharply from 28,750 in 1990 to 66,320 in 2019, and both presented the upward temporal trend annually. Whereas the EAPC of age-standardized DALYs demonstrated a negative temporal trend despite of increasing DALYs from 1,118,120 in 1990 to 1,723,590 in 2019. Moreover, graver IE burden was prone to males and aged patients. Meanwhile, different SDI regions had different disease burden, correlation analyses indicated that SDI presented a positive association with ASIR (R=0.58, P<0.0001), no association with ASDR (R=-0.06, P=0.10), and negative association with age-standardized DALYs rate (R=-0.40, P<0.0001). Finally, we discovered the positive associations of EAPC of ASRs with SDI in 2019, while little associations with ASIR in 1990.Conclusion: Generally, the overall burden of infective endocarditis is ever-increasing, and the incidence, mortality and disability-adjusted life years present a huge heterogeneity in gender, age and different regions. The results may be useful for policy makers and medical staffs in response to endocarditis and to formulate cost-effective interventional measures.