Risk Factor Analysis for 30-day Mortality After Surgery for Infective Endocarditis

Area of Science:

• Cardiology
• Cardiac Surgery
• Infectious Diseases

Background:

• Infective endocarditis (IE) presents significant mortality challenges.
• Existing surgical risk scores for IE are inadequate.
• This study aimed to identify key risk factors for 30-day mortality post-IE surgery.

Purpose of the Study:

• To analyze pre- and intraoperative risk factors associated with 30-day mortality in patients undergoing surgery for infective endocarditis.
• To identify predictors that can inform patient counseling and surgical team management.

Main Methods:

• A retrospective analysis of 438 consecutive patients who had surgery for IE between 2002 and 2020.
• Patients were divided into 30-day survivors (82.6%) and nonsurvivors (17.4%).
• Logistic regression and univariable analyses were performed to identify risk factors.

Main Results:

• Nonsurvivors were older, had higher EuroSCORE II, and more frequently presented with left ventricular dysfunction, renal insufficiency, chronic dialysis, diabetes, NYHA class IV, and cardiogenic shock.
• Prevalence of Staphylococcus aureus and prosthetic valve endocarditis (PVE) was higher in nonsurvivors, while Streptococcus viridans and isolated aortic valve endocarditis were more common in survivors.
• Logistic regression identified female gender, chronic dialysis, cardiogenic shock, NYHA IV, PVE, prolonged cardiopulmonary bypass time, and mitral valve surgery as significant predictors of 30-day mortality.

Conclusions:

• Significant risk factors for 30-day mortality in IE surgery are largely unmodifiable.
• These identified factors are essential for preoperative patient counseling.
• Awareness of these predictors allows for more meticulous surgical management and improved patient care.