The More Vulnerable, the More Fatal: Predictors for Mortality in Patients with Dreadful Infective Endocarditis

Introduction:Infective endocarditis and its complications are highly associated with morbidity and mortality.In this study, we aimed to determine independent predictors for mortality in patients with infective endocarditis. Materials and Methods:In this single-center retrospective study, all patients with definitive infective endocarditis, according to the modified Duke criteria, between January 2015 and December 2023 were included.Mortality was defined as in-hospital all-cause death.Univariate analysis and multivariate regression models were performed.Results: A total of 69 patients were included.Of those, 55.1% were male, and the median age was 61 (50-71) years.The rate of in-hospital mortality was 46.4% (n= 32).The most common comorbidity was chronic kidney disease (n= 34, 49.3%).Twenty-three patients (33.3%) were receiving chronic dialysis.Staphylococcus aureus bacteremia was observed in 36 (52.2%) patients.The rate of methicillin resistance among S. aureus was 38.9% (n= 14).Fifty-six patients (81.2%) had at least one complication.In univariate analysis, age (p= 0.002), presence of at least one comorbidity (p= 0.036), chronic kidney disease (p= 0.043), prosthetic valve endocarditis (p= 0.036), bacteremia with methicillin-resistant S. aureus (p= 0.043), and presence of complication (p= 0.023) were associated with in-hospital mortality.In multivariate regression models, advanced age (OR= 1.06, CI= 1.01-1.11,p= 0.027), prosthetic valve endocarditis (OR= 12.17, CI= 1.18-125.67,p= 0.036), and presence of complication (OR= 6.18, CI= 1.08-35.24,p= 0.040) were independent predictors for in-hospital mortality. Conclusion:Infective endocarditis is a complex and dreadful disease, with nearly half of the patients succumbing to it.Although chronic kidney disease was the most common comorbidity among patients with infective endocarditis, neither chronic kidney disease nor chronic dialysis was independently associated with in-hospital mortality.Older adults with complicated prosthetic valve endocarditis should be prioritized as high-risk targets in the management of infective endocarditis.