Abstract

BACKGROUND

Endocarditis is a serious cardiovascular infection associated with high mortality and disability. Its global epidemiological patterns and long-term trends have not been comprehensively characterized.

METHODS

Data from the Global Burden of Disease (GBD) Study 1990-2021 were used to evaluate the prevalence, incidence, disability-adjusted life years (DALYs), and Deaths of endocarditis across 204 countries and territories. Temporal trends were analyzed using percentage change and estimated annual percentage change (EAPC), stratified by Socio-demographic Index (SDI), region, age, and sex.

RESULTS

Between 1990 and 2021, the absolute number of endocarditis cases increased: prevalence by 14%, incidence by 34%, DALYs by 26%, and Deaths by 29%. Conversely, age-standardized rates declined (EAPCs: -0.58 for prevalence, -0.09 for incidence, -0.33 for DALYs, -0.29 for Deaths). Females had higher prevalence and incidence, while males experienced greater Deaths and DALYs burdens. The burden was concentrated among individuals aged ≥ 65 years, with slight increases observed in children under 5 in low-SDI regions. High-SDI regions showed declining trends in age-standardized metrics, whereas low- and middle-SDI regions exhibited increases. Correlation analysis indicated a moderate association between SDI and prevalence (R = 0.543), a stronger association with incidence (R = 0.770), and a weak correlation with DALYs (R = 0.063).

CONCLUSIONS

The absolute burden of endocarditis has increased globally despite declining standardized rates, with older adults and low-SDI populations disproportionately affected. These findings highlight the need for enhanced surveillance and equitable access to care, although limited clinical detail in the GBD framework restricts direct clinical interpretation.

MeSH

Incidence, Cardiovascular Diseases, Endocarditis, Prevalence