Temporal trends in mortality related to infective endocarditis and stroke in the United States

Abstract

Introduction: Infective endocarditis (IE) remains a significant cause of mortality, and its neurological complication stroke is associated with worsened outcomes. However, the temporal trends in mortality when both conditions co-occur remain underexplored.

Aims: To analyze mortality trends in Infective Endocarditis with Stroke as a contributing cause of death using the CDC Multiple Causes of Death (MCD) database during the period 1999-2020.

Methodology: A retrospective observational study was conducted using the CDC MCD database to assess mortality trends in individuals aged 25 years and older in the United States from 1999 to 2020. Deaths where Infective Endocarditis (ICD-10:I33.0) was listed as the underlying cause and Stroke (ICD-10:I63- Cerebral Infarction) as a contributing cause were analyzed. Data were stratified by age, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated.

Results: From 1999 to 2020, a total of 1761 deaths were recorded in the United States of America. The AAMR for Infective Endocarditis with Stroke showed a decline followed by an increasing trend over time (APC: 8.30%). The highest mortality was observed in Males, White Adults and Metropolitan areas & Medical facilities. Temporal trends showed an initial decline in mortality followed by an increase, with disparities noted across demographic and geographic factors.

Conclusions: This study highlights significant mortality trends increasing in Infective Endocarditis with Stroke, with disparities by gender, race, and location. Results emphasise the need for targeted prevention strategies and improved healthcare access.

Keywords: Age-Adjusted Mortality Rate, CDC MC, Infective Endocarditis, Retrospective study, Stroke