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

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Public Health

Background:

• Rising endocarditis hospitalizations and healthcare costs in the US over two decades.
• Need to understand trends in cardiac surgery for endocarditis.
• Characterize patient demographics and outcomes for these procedures.

Purpose of the Study:

• Assess trends in cardiac surgical procedures for endocarditis.
• Analyze patient demographics and outcomes.
• Evaluate changes in endocarditis causes and surgical results.

Main Methods:

• Retrospective, multicenter study using prospectively collected data.
• Adults undergoing open valvular surgical operations for endocarditis in Michigan (2008-2022).
• Cochran-Armitage trend test for analyzing patient characteristics, endocarditis cause, and outcomes.

Main Results:

• Proportion of valvular operations for endocarditis rose from 3.8% (2008) to 8.9% (2022).
• Mortality decreased from 13.6% to 9.0%, but not statistically significant.
• No significant trend observed in healthcare-associated endocarditis cases.

Conclusions:

• Surgical valvular operations for endocarditis have steadily increased in Michigan (2008-2022).
• No significant changes noted in operative mortality, patient risk profiles, or healthcare-associated endocarditis incidence.
• Increased surgical intervention for endocarditis occurred without significant shifts in outcomes or risk factors.