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Patient characteristics, valve surgery and 1-year mortality in left-sided Staphylococcus aureus infective

Sikander Tajik Nielsen1, Peter Laursen Graversen2, Katra Hadji-Turdeghal2

  • 1Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark sikander.tajik.nielsen.02@regionh.dk.

Heart (British Cardiac Society)
|November 20, 2025
PubMed

Insights

Surgery for Staphylococcus aureus infective endocarditis (SA-IE) was associated with lower 1-year mortality, but not significantly different in-hospital mortality. Patient characteristics and disease severity varied between surgical and non-surgical groups.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • Staphylococcus aureus infective endocarditis (SA-IE) has high mortality rates (30-40%).
  • Guidelines suggest surgery for SA-IE, but comparative outcome data are limited.
  • Lack of robust evidence hinders definitive treatment strategy selection.

Purpose of the Study:

  • To compare outcomes between surgical and non-surgical treatment for left-sided SA-IE.
  • To analyze in-hospital and 1-year mortality in SA-IE patients.
  • To evaluate the impact of surgical intervention on SA-IE patient survival.

Main Methods:

  • Retrospective cohort study using the Danish endocarditis registry (2016-2021).
  • Identified 918 patients with left-sided SA-IE, categorized into surgical (17%) and non-surgical (83%) groups.
  • Analyzed baseline characteristics and mortality using Cox regression.

Main Results:

  • Surgical patients were younger, had fewer comorbidities but presented with more severe disease (larger vegetations, sepsis, emboli).
  • Crude in-hospital mortality was lower in the surgical group (17% vs. 28%).
  • Adjusted in-hospital mortality showed no significant difference, but 1-year mortality was significantly lower in surgical patients (HR 0.61).

Conclusions:

  • Surgical intervention for SA-IE was linked to reduced 1-year mortality.
  • Despite initial disease severity, surgical patients experienced better long-term survival.
  • Heterogeneity in patient populations limits definitive conclusions on treatment superiority.
Abstract

Keywords:
Cardiac Surgical ProceduresCohort StudiesEndocarditisTreatment Outcome

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