Infective endocarditis

There are no comprehensive studies that have looked at overall prognosis in patients with IE. Heart failure remains the single greatest predictor of prognosis in patients, regardless of the offending micro-organism. Other indicators of mortality include cerebral complications, vegetation length >10 mm, and failure to undertake surgery when indicated.[91]Habib G, Erba PA, Iung B, et al. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J. 2019 Oct 14;40(39):3222-32. https://www.doi.org/10.1093/eurheartj/ehz620 http://www.ncbi.nlm.nih.gov/pubmed/31504413?tool=bestpractice.com Surgery, if indicated, has been associated with a lower overall mortality; however, patients with definitive indications for surgery tend to be critically ill and carry a high intra-operative mortality rate.[92]Sexton DJ, Spelman D. Current best practices and guidelines: assessment and management of complications of infective endocarditis. Cardiol Clin. 2003 May;21(2):273-82. http://www.ncbi.nlm.nih.gov/pubmed/12874898?tool=bestpractice.com

As the population ages, IE is becoming more frequently seen, with trends towards worsening outcomes.[29]Selton-Suty C, Hoen B, Grentzinger A, et al. Clinical and bacteriological characteristics of infective endocarditis in the elderly. Heart. 1997 Mar;77(3):260-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC484694 http://www.ncbi.nlm.nih.gov/pubmed/9093046?tool=bestpractice.com Mortality of IE in older patients is higher than in younger patients: age, cerebral embolism, and prosthetic valve endocarditis have been shown to be risk factors for the observed increase in mortality.