# 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.

## Key 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.