Trends in Surgery for Endocarditis: 15-Year Experience From a Statewide Quality Collaborative

During the past 2 decades, there has been a rise in endocarditis-related hospitalizations and overall health care expenditures in the United States. The objectives of this study were to assess trends in number of cardiac surgical procedures in which endocarditis was the indication for operation and to characterize the demographics and outcomes of patients receiving cardiac surgical procedures for endocarditis.

This was a retrospective, multicenter investigation of prospectively collected data from a statewide database of adults undergoing open valvular surgical operations for the treatment of endocarditis in Michigan from January 2008 through June 2022. Trends in patient characteristics, endocarditis cause, and surgical outcomes were analyzed by Cochran-Armitage trend test.

In 2008, 3.8% of all valvular operations were performed for endocarditis, with the incidence increasing to 8.9% in 2022 (P < .001). Mortality rates decreased during the study period, from 13.6% in 2008 to 9.0% in 2022, but the trend was not statistically significant (P = .4). There was no discernible trend in the rate of health care-associated endocarditis cases.

Between 2008 and 2022, surgical valvular operations for endocarditis have steadily increased in Michigan without significant changes in operative mortality rates, patient characteristics, operative risk profile, or incidence of health care-associated endocarditis.