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Infective endocarditis: Epidemiology and prognosis of a contemporary cohort
Session:
Sessão de Posters 24 - Endocardite infeciosa: estratificação de risco, tratamento e desfechos
Speaker:
João Pedro Faria
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.2 Infective Endocarditis – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
João Pedro Ferreira Faria; Bárbara Antunes Rocha; Vera Araújo; Carla Oliveira Ferreira; Filipe Silva Vilela; Mónica Dias; Sofia Fernandes; Inês Conde; Catarina Vieira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Infective Endocarditis (IE) remains a life-threatening disease whose incidence and mortality have not declined despite advances in diagnostics and management. This study aimed to characterize contemporary IE cases and identify predictors of in-hospital mortality and survival at one and five years after the acute event<span style="color:black">. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">This retrospective cohort study included patients hospitalized at a tertiary hospital with definite or possible IE between January 2014 and December 2020. Demographic, clinical, microbiological, imaging, therapeutic, and outcome data were analyzed using univariate and multivariate logistic regression to identify variables associated with and determine independent predictors of in-hospital death. Survival was estimated using Kaplan–Meier analysis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">The study included 158 patients (mean age 64.9±15.9 years, 63.3% male). IE was community-acquired in 60.1%, healthcare-associated in 36.1%, and related to intravenous drug use in 3.8%. The most frequent predisposing cardiac factor was prosthetic valve material (29.1%), <span style="color:black">although native valves were more often involved (70.3%) than prosthetic valves (17.1%)</span>. <em>Staphylococcus aureus</em> (33.9%) and <em>Enterococcus spp.</em> (16.1%) were the most frequently isolated agents. Severe valvular regurgitation occurred in 57.5%. Cardiac surgery was indicated in 55.7% but performed in only 32.3%. Major in-hospital complications included severe valve dysfunction (46.8%), embolic events (43.7%), and acute kidney injury (38.0%). In-hospital mortality was 32.9%, mainly due to multiorgan failure and septic shock. Independent predictors of in-hospital death were age ≥65 years (OR=2.43, p=0.046), hypertension (OR=2.96, p=0.032), constitutional symptoms (OR=4.53, p=0.010), leukocytosis (OR=2.90, p=0.008), and left-ventricular dysfunction (OR=4.66, p=0.016). Post-discharge mortality reached 16.3% at 1 year and 44.9% at 5 years.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusions:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">In patients with IE, in-hospital mortality remains high, largely reflecting disease severity and <span style="color:black">lower-than-expected cardiac surgery rate</span>. Early identification of high-risk patients may guide closer monitoring and expedite surgical management, potentially improving outcomes.</span></span></p>
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