Prognosis

There are no comprehensive studies that have looked at overall prognosis in patients with IE. Left-sided IE tends to have a poorer prognosis, with higher morbidity and mortality than right-sided IE.​​[6][7]​​ Congestive heart failure remains the single greatest predictor of prognosis in patients, regardless of the offending microorganism. Other indicators of mortality include cerebral complications, vegetation length >10 mm, moderate to severe heart failure, bacterial etiology other than Viridans streptococci and failure to undertake surgery when indicated.[20][130]​​​​​ 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 intraoperative mortality rate.[20][131]​​​​

As the population ages, IE is becoming more frequently seen, with trends towards worsening outcomes.[61]​ Mortality of IE in elderly patients is higher than in younger patients: age, cerebral embolism, and prosthetic valve endocarditis have been shown to be risk factors for the increased mortality.

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