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New Insights into Mortality-Related Risk Factors in Infective Endocarditis: Results from the Brandenburg State
Roya Ostovar1, Filip Schroeter1, Frarzane Seifi Zinab2
1Department of Cardiovascular Surgery, Heart center Brandenburg, Faculty of Health Sciences Brandenburg, University Hospital Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.
The Thoracic and Cardiovascular Surgeon
|October 26, 2023
Summary
This study highlights high mortality rates in endocarditis patients, identifying key preoperative risk factors like age and comorbidities. Early intervention and optimized procedures can improve outcomes for this complex condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Endocarditis presents a significant health challenge with increasing incidence in Europe.
- High complication and mortality rates underscore the need for improved management strategies.
- Multimorbidity in an aging population complicates treatment of endocarditis.
Purpose of the Study:
- To analyze factors influencing mortality in endocarditis patients.
- To identify preoperative and intraoperative risk factors associated with adverse outcomes.
- To provide insights for optimizing treatment strategies based on registry data.
Main Methods:
- Prospective, multicenter endocarditis registry initiated in 2020.
- Collection of perioperative risk factors, comorbidities, diagnostics, complications, and mortality.
- Midterm analysis of data from the first 313 patients.
Main Results:
- In-hospital and 1-year mortality rates were 28.4% and 40.9%, respectively.
- Significant preoperative risk factors included age, EuroSCORE II, coronary artery disease, LVEF, SIRS, heart failure, renal failure, and hypalbuminemia.
- Peri-annular abscess, perforation, shunt, and cardiopulmonary bypass time were associated with increased mortality.
Conclusions:
- Endocarditis patient management is complex, with significant mortality.
- Preoperative factors such as hypalbuminemia and procedure duration are modifiable.
- Optimized albumin substitution and carefully planned hybrid approaches may improve outcomes.
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