Indicators of In-Hospital Mortality in Infective Endocarditis: A Single-Center Retrospective Study

TL;DR

This study identifies risk factors for in-hospital death in patients with infective endocarditis, emphasizing the importance of early intervention.

Contribution

The study provides insights into clinical indicators of mortality in infective endocarditis patients at a single hospital.

Findings

Fatal outcomes were more common in older male patients with chronic kidney failure and malignancies.

Heart failure and septic shock were significantly more prevalent in patients who died.

Surgery was less common in patients with fatal outcomes compared to survivors.

Abstract

Infective endocarditis (IE) is associated with severe complications and high in-hospital mortality, ranging from 15% to 30%. Indicators of fatal outcome include the development of heart failure, septic shock, local uncontrolled infection or periannular complications, Staphylococcus aureus as a causative agent, negative blood cultures, and unoperated patients. This retrospective study determined clinical features and the indicators of in-hospital mortality in a cohort of 96 patients hospitalized in the cardiology clinic of the university hospital from January 1, 2018, to January 1, 2022, with definite infective endocarditis. Two-thirds of the patients were male, with a mean age of 53.5 years. Subjects with a fatal outcome (17.7%) were dominantly male (82%), and significantly older than the survivor group (61.6 vs. 51.7 years; p=0.014). There was a significantly higher presence of chronic kidney failure and malignancies in the fatal outcome subjects. Most significant complications of IE were heart failure (94.1% of subjects with a fatal outcome and 16.7% of survivors, p<0.001) and septic shock (82.4% vs. 1.3%; p<0.001). Surgery was performed in 11.8% of subjects with a fatal outcome and 57.7% of survivors (p=0.001). Cardiogenic shock and septic shock were the most common causes of death (35.3% and 23.5%, respectively). This retrospective study indicated the need for early recognition of high-risk IE patients and conservative and surgical treatment in the prevention of complications and fatal outcomes.