Body Weight's Role in Infective Endocarditis Surgery.

Area of Science:

• Cardiology
• Surgical Outcomes
• Obesity Research

Background:

• Infective endocarditis (IE) is a serious infection affecting heart valves, often requiring surgical intervention.
• The role of body mass index (BMI) in surgical outcomes for IE patients is not fully understood.
• Understanding how BMI influences complications and survival is crucial for optimizing patient care.

Purpose of the Study:

• To investigate the association between body mass index (BMI) and outcomes in patients undergoing surgery for infective endocarditis (IE).
• To determine if obesity is an independent risk factor for mortality and complications in this patient group.

Main Methods:

• A single-center observational analysis of consecutive patients surgically treated for IE.
• Patients were categorized into six BMI groups based on WHO classifications.
• Outcomes, including postoperative complications and survival rates, were analyzed across BMI groups.

Main Results:

• Patients with class II and III obesity experienced higher rates of acute kidney injury, sternal wound infection, and worse 30-day and long-term survival.
• Multivariable analysis did not identify obesity as an independent risk factor for 30-day mortality.
• Age > 60, reduced left ventricular ejection fraction (LVEF) < 30%, staphylococcal infection, and prosthetic valve endocarditis were correlated with mortality.
• BMI demonstrated poor discrimination for predicting 30-day mortality but fair discrimination for sternal wound infection.

Conclusions:

• Obesity is linked to increased comorbidities, complications, and postoperative mortality in IE patients but is not an independent mortality risk factor.
• While BMI is a poor predictor of death, it serves as a valuable predictor for sternal wound infections following IE surgery.