Evaluation of parameters predicting in-hospital mortality and septic embolisms in patients with infective endocarditis

Introduction:
Infective endocarditis (IE) is the infection of the cardiac endothelium and heart valves. The incidence of IE has recently increased due to the widespread use of cardiac device therapies and prosthetic heart valves. Despite modern medical and surgical treatment methods, morbidity and mortality are still high, and it leads to serious complications. Evaluation of predictive factors leading to septic embolism, which is one of the most important complications in terms of mortality and morbidity, is important for improving outcomes in infective endocarditis.

Aim:
In this study, we aimed to determine the predictive parameters of in-hospital mortality and septic embolism in patients with IE.

Material and methods:
This was a retrospective cohort study. The patients were divided into two groups: group 1 (septic embolism or mortality +, 21 patients) and group 2 (septic embolism or mortality –, 43 patients). ROC analysis was performed to determine the cut-off value of the predictive parameters. Univariable and multivariable regression analysis was performed to identify parameters significantly associated with in-hospital mortality/septic embolism in infective endocarditis.

Results:
A total of 64 patients diagnosed with IE were included in the study. In the multivariable regression analysis, the parameters vegetation size (OR = 1.227; 95% CI: 1.019–1.477, p = 0.031), aortic valve vegetation (OR = 0.088; 95% CI: 0.009–0.820, p = 0.033), mitral valve vegetation (OR = 0.082; 95% CI: 0.009–0.760, p = 0.028), albumin (OR = 0.185; 95% CI: 0.039–0.889, p = 0.035) and D-dimer (OR = 1.004; 95% CI: 1.000–1.009, p = 0.045) were found to be independent predictors for septic embolism and mortality in IE patients.

Conclusions:
Vegetation size, high D-dimer and low serum albumin levels are predictors of in-hospital mortality and septic embolism in patients with IE.