Aim To provide a contemporary analysis of incidence trends of infective endocarditis (IE) with its changing epidemiology over the past two decades in Europe. Methods A systematic review was conducted at the Mayo Clinic, Rochester. Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus and Web of Science were searched for studies published between 1 January 2000 and 30 November 2020. All studies were independently reviewed by four referees and those that included a population-based incidence of IE in patients, irrespective of age, in Europe were included. Least squares regression was used to estimate pooled temporal trends in IE incidence. Results Of 9138 articles screened, 18 studies were included in the review. Elderly men predominated in all studies. IE incidence increased 4.1% per year (95% CI 1.8% to 6.4%) in the pooled regression analysis of eight studies that included comprehensive and consistent trends data. When trends data were weighted according to population size of individual countries, an increase in yearly incidence of 0.27 cases per 100 000 people was observed. Staphylococci and streptococci were the most common pathogens identified. The rate of surgical intervention ranged from 10.2% to 60.0%, and the rate of inpatient mortality ranged from 14.3% to 17.5%. In six studies that examined the rate of injection drug use, five of them reported a rate of less than 10%. Conclusion Based on findings from our systematic review, IE incidence in Europe has doubled over the past two decades in Europe. Multiple factors are likely responsible for this striking increase. Trial registeration number CRD42020191196. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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21世纪欧洲感染性心内膜炎的发病率不断上升

目的 对过去二十年欧洲感染性心内膜炎 (IE) 的流行病学变化进行当代分析。方法 在罗彻斯特梅奥诊所进行了系统评价。Ovid EBM Reviews、Ovid Embase、Ovid Medline、Scopus 和 Web of Science 检索了 2000 年 1 月 1 日至 2020 年 11 月 30 日之间发表的研究。所有研究均由四位审稿人独立审查，其中包括患者中基于人群的 IE 发病率，无论年龄大小，在欧洲都包括在内。最小二乘回归用于估计 IE 发生率的汇总时间趋势。结果 在筛选的 9138 篇文章中，18 项研究纳入综述。在所有研究中，老年男性占主导地位。在包括全面且一致的趋势数据的八项研究的汇总回归分析中，IE 发病率每年增加 4.1%（95% CI 1.8% 至 6.4%）。当根据各个国家的人口规模对趋势数据进行加权时，观察到每 10 万人的年发病率增加了 0.27 例。葡萄球菌和链球菌是最常见的病原体。手术干预率为10.2%至60.0%，住院死亡率为14.3%至17.5%。在调查注射吸毒率的六项研究中，其中五项报告的比率低于 10%。结论 根据我们的系统评价结果，欧洲 IE 的发病率在过去二十年中翻了一番。这一惊人的增长可能是由多种因素造成的。试用注册号CRD42020191196。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。