Hospital mortality due to infective endocarditis: Analysis of risk factors in a developing country

Abstract

Introduction: Infective endocarditis (IE) is a disease with high mortality that, in recent decades, has experienced changes in its epidemiology, pathogenesis, and microbiology. Therefore, understanding its landscape and risk factors for mortality is essential. Objective: To identify the epidemiological, clinical, laboratory, etiological, and echocardiographic profile of patients hospitalized with IE and to determine predictors for in-hospital mortality. Methods: This was a retrospective observational study that analyzed medical records of patients hospitalized for IE in a tertiary center from 2007 to 2023. Patients with a definitive diagnosis of IE according to the Duke criteria were included, while those without a definitive diagnosis, those transferred from other facilities, and minors were excluded. Univariate logistic regression was performed to assess the effect of each variable on in-hospital mortality, with a p-value considered significant if below 0.05. Results: A total of 49 patients were included, most of whom were male (67.4%) with a mean age of 55.5 years. The main etiological agent was Staphylococcus spp. (56.66%), and the mitral valve was the most affected (60.86%). Stroke occurred in 28.57% of patients, and the in-hospital mortality rate was 36.7%. Identified predictors included prior stroke (p=0.017), stroke during hospitalization (p=0.015), and length of hospital stay (p=0.01). Conclusion: IE leads to high mortality, with prior stroke, stroke during hospitalization, and length of hospital stay identified as predictors of in-hospital mortality.