Clinical predictors of mortality from infective endocarditis.

A cohort study with prospective data collection was conducted to determine which risk factors and outcome variables are statistically significant clinical predictors of mortality from infective endocarditis. A study was performed from an eleven-year, hospitalization cohort (N=11,230) in which the data were collected prospectively. The study examined 21 potential risk factors and 14 outcome variables. The risk factors were categorized into these various groups: patient factors, cardiac factors, co-morbidities, operative factors, infectious factors, and complications. The outcome variables were categorized into operative factors, infectious factors, and complications. Inclusion criteria included patients with endocarditis (N=87). Longer operative time, operative complications, and postoperative complications. Overall mortality was 11.5 percent (N=10). Endocarditis patients who died were significantly older (p=0.023) and had a longer pump time (p=0.017) than those who survived. Endocarditis patients who died were more likely to experience an unstable hemodynamic status (p=0.012). There was a significant difference between survival and non-survival of patients with endocarditis on nine outcome variables. They were more likely to require a re-operation for bleeding (p=0.034). Renal complications (p=0.016), neurological complications (p=0.004), pulmonary complications (p=0.001), intra-operative complications (p=0.035), and IAPB (p<0.001) were all more likely to occur in endocarditis patients who died. There are risk factors that serve as predictors of mortality from infectious endocarditis. These include age greater than 65 years, longer pump time, and unstable hemodynamic status. Outcome variables that reflected significant mortality included operative complications and post-operative complications. These factors may identify those patients with infective endocarditis eligible for more aggressive treatment.