Impact of surgery on the mortality of infective endocarditis in a hospital without cardiac surgery

Abstract

Background. Infective endocarditis has a high morbidity and mortality and requires a coordinated medical-surgical management. The objective was to analyse the impact of surgery on mortality in a hospital without cardiac surgery. Material and methods. Evaluation of a prospective cohort of patients with infective endocarditis diagnosed between August 2011 and January 2016 according to modified Duke’s criteria. Results. Sixty-four patients were included, of whom seventeen patients were operated (26.6%). Mortality was 32.8% and it was associated with chronic obstructive pulmonary disease history, staphylococci coagulase-negative and the appearance of complications, as valvular insufficiency and embolisms in the central nervous system; cardiac surgery was not associated with mortality. Four patients (6,6%) were not operated despite indication of cardiac surgery. The main reason for not been intervened was the poor presurgical prognosis (44.7%). Conclusions. Mortality due to infective endocarditis in a hospital without cardiac surgery is high. The need for interhospital teams is strengthened.