O2064: Incidence and Prevalence of Stroke and All-cause Mortality in Pediatric Infective Endocarditis in the Last Decade

Background: Infective endocarditis (IE) can lead to various complications, including neurological events like stroke, and is associated with high morbidity and mortality. However, there is limited recent data on the incidence of stroke and mortality in pediatric patients with IE. This study aims to investigate the trends in the prevalence and incidence of ischemic and hemorrhagic stroke, as well as all-cause mortality, in children with infective endocarditis, offering valuable insights into the evolving risks and the need for targeted interventions in this vulnerable population.

Methods: This retrospective cohort study utilized data from the TriNetX US Collaborative Network. We queried the network for patients aged 0 to 18 with an ICD-10 diagnosis of infective endocarditis from January 2015 to December 2024. Among these patients, individuals with ischemic stroke, hemorrhagic stroke, and all-cause mortality were identified. Logistic regression was used to analyze trends in the incidence and prevalence of these three outcomes over the ten years.

Results: The final cohort comprised a total of 10,543 patients with infective endocarditis. There was a slight increase in the prevalence of ischemic stroke among these patients, rising from 1.25% in 2015 to 2.12% in 2024. The incidence rate also increased from 1.42 cases per 100,000 person-days to 2.85 cases per 100,000 person-days. Additionally, the prevalence of hemorrhagic stroke rose from 0.46% to 0.89%, while the incidence rate of hemorrhagic stroke increased from 6.43 cases per 100,000 person-days to 9.60 cases per 100,000 person-days. Furthermore, the prevalence of all-cause mortality grew from 0.54% to 0.73%, and the incidence rate escalated from 1.60 cases per 100,000 person-days to 2.48 cases per 100,000 person-days.

Conclusion: This study highlights an upward trend in both the prevalence and incidence of ischemic and hemorrhagic stroke, as well as all-cause mortality, among pediatric patients with infective endocarditis. These trends reflect the growing burden of neurological complications and mortality in this group. The findings emphasize the need for improved monitoring and preventive measures to address these rising risks.