Key result
Acute renal failure linked to ~33-fold higher in-hospital mortality in late prosthetic valve endocarditis.
Why the study?
Late prosthetic valve infective endocarditis (LPVIE) is associated with high mortality, but risk factors for mortality and clinical characteristics require further evaluation.
Observational (n=394)
Yes
Answers are grounded in this paper and cite their sources.
Late prosthetic valve infective endocarditis carries a high in-hospital mortality of 31%, which is strongly driven by complications such as acute renal failure, paravalvular abscesses, and failure to undergo indicated surgery.
Objectives To evaluate episodes of late prosthetic valve infective endocarditis (LPVIE) and mortality associated risk factors. Methods We conducted an observational study of LPVIE cases recorded between 2006 and 2023 at two Brazilian cardiac surgery centres. Adults with a definite diagnosis of LPVIE according to the modified Duke criteria were included. Results A total of 394 episodes were analyzed; 63.2% affected males. The mean age was 54.8 ± 17.39 years. Fever occurred in 77.9%, embolization in 20.6%, vegetations in 49.1% and paravalvular abscesses (PA) in 20.6% of patients. Blood cultures were negative in 21.1%. Surgery was indicated in 68.5% and performed in 81.9%. In-hospital mortality was 31%. Risk factors for mortality were acute renal failure, OR 32.80 (95% CI 13.38–80.38; p < 0.0001); PA, OR 9.37 (CI 3.23–27.15; p < 0.0001); failure to undergo surgery when indicated, OR 6.58 (CI 1.88–23.06; p = 0.003); acute heart failure, OR 4.65 (CI 1.95-11.09; p = 0.0005); dehiscence, OR 4.05 (95% CI 1.15-14.21; p = 0.029); age ≥ 60 years, OR 1.05 (95% CI 1.02-1.09; p = 0.0004). Conclusion LPVIE was associated with high mortality and complications. Early identification of structural complications and timely surgical evaluation may improve prognosis.
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Pompeo et al. (2026) conducted an observational in Late prosthetic valve infective endocarditis (n=394). Acute renal failure vs. Absence of acute renal failure was evaluated on In-hospital mortality (OR 32.80, 95% CI 13.38-80.38, p=<0.0001). Acute renal failure was the strongest risk factor for in-hospital mortality (OR 32.80; 95% CI 13.38-80.38; p<0.0001) in patients with late prosthetic valve infective endocarditis.
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