A Comprehensive Evaluation of Clinical Variables and Their Association with in Hospital Mortality in Infective Endocarditis Cases

Objectives: Infective endocarditis (IE) remains a significant clinical challenge due to its high morbidity and mortality rates. Prognosis is influenced by patient characteristics, causative microorganisms, complications, and echocardiographic findings. The Barcelona Bio-Heart Failure (BCN Bio-HF) Risk Score, widely used in heart failure, has not yet been evaluated in IE. This study aimed to assess the association between the BCN score and in-hospital mortality in patients with IE. Methods: This retrospective, single-center observational study included 108 patients diagnosed with IE. Patients were divided into two groups based on the occurrence of in-hospital mortality, which was defined as any death occurring during hospitalization. Clinical, demographic, laboratory, and echocardiographic data were compared between the groups. Results: Among 108 patients, 29 (26.9%) experienced in-hospital mortality. Compared to survivors, non-survivors were older (p=0.046) and had a higher prevalence of chronic kidney disease (p=0.041). Staphylococcus aureus and methicillin-resistant strains were more common in the mortality group (p=0.043 and p=0.04, respectively). Echocardiographic findings showed a lower ejection fraction (p=0.03), higher pulmonary artery systolic pressure (p=0.017), and larger vegetation size (p=0.033) in non-survivors. Mechanical complications were also more frequent (p=0.017). Laboratory results revealed lower hemoglobin (p=0.012) and higher levels of WBC (p=0.035), CRP (p=0.01), procalcitonin (p=0.02), NT-proBNP (p=0.008), and BCN Bio-HF risk score (p=0.008) in patients with in-hospital mortality. Conclusion: The BCN Bio-HF risk score showed potential in predicting in-hospital mortality in infective endocarditis by integrating clinical and biomarker data. Future studies should aim to develop IE-specific prognostic models incorporating dynamic clinical variables and novel biomarkers to enhance risk stratification and guide management.