Early Predictors of In-Hospital Death in Infective Endocarditis

Abstract

Background-Data on early determinants of outcome in infective endocarditis (IE)

Association Between Valvular Surgery and Mortality Among Patients With Infective Endocarditis Complicated by Heart Failure

“…9,[21][22][23] In the present work, HF occurred in 33% of definite cases of infective endocarditis, with a high percentage of severe (NYHA class III or IV) symptoms occurring shortly after diagnosis of endocarditis. Clinical characteristics previously associated with the development of HF in patients with infective endocarditis include new heart murmur, aortic valve infective endocarditis, high comorbidity index, and severe valvular regurgitation.…”

“…The in-hospital mortality rates reported in smaller studies of left-sided infective endocarditis and HF have ranged from 24% to 43% 7,21,22,27 and have been associated with uncontrolled infection, major neurologic event, and S aureus infective endocarditis. 22 Later onset of HF in the course of infective endocarditis has also been associated with higher mortality.…”

Validated Risk Score for Predicting 6‐Month Mortality in Infective Endocarditis

“…A simplified weighted ICE prognostic score was developed for clinical use, and these prognostic factors for mortality were categorized into 4 groups of variables: host factors, IE characteristics, complications, and treatment with or without surgery. Many of the variables predictive of 6‐month mortality, ranging from ≈10% to >50% across risk quintiles, have been associated previously with mortality during the index hospitalization,1, 13 and our risk score emphasizes the additive prognostic associations of these clinical characteristics.…”

“…Previous studies have evaluated clinical characteristics associated with mortality in IE, generally focusing on in‐hospital mortality 13. In the ICE‐PCS cohort, in‐hospital mortality was associated with IE complications of prosthetic or mitral valve IE, pulmonary edema, paravalvular complication, and S aureus infection 1.…”

“…The model included variables that were selected a priori by an experienced cardiologist (A.W.) and from practice guidelines6, 7 and previous studies1, 12, 13 because those would be evaluated in the decision to treat IE with surgery. These variables were age >70 years, history of hemodialysis, history of intravenous drug use, time of ≥1 month since first IE manifestation, paravalvular complication, New York Heart Association class 3 or 4 (versus 1 or 2), aortic valve vegetation, new mitral or aortic valve regurgitation, and causative microorganism ( S aureus , coagulase‐negative staphylococci, and viridans group streptococci).…”