Infective Endocarditis: Still a Deadly Disease

The important issue of in-hospital mortality in infective endocarditis (IE) is discussed by Marques et al. In-hospital mortality in the International Collaboration in Endocarditis (ICE) cohort (2000-2005) was 18%, similar to the 17% in the large European cohort recently published, both unacceptably high, considering that most patients included were from developed countries and voluntary registries.

In the present article, in-hospital mortality was 42/134 (31.3%), higher than expected. The identified risk factors for in-hospital mortality were Staphylococcus aureus etiology, negative blood-cultures, evidence of valve obstruction in echocardiography, heart failure secondary to IE and septic shock. Cardiac surgery was protective for mortality. To me, the most important message is “surgery was protective for mortality”. This has been shown in several studies.^–

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