Key result
Surgical timing for infective endocarditis shows no significant difference in in-hospital mortality.
Why the study?
The optimal timing of surgery in patients with infective endocarditis without an urgent indication remains uncertain.
Does the timing of surgery (<7 days, 7-14 days, or >14 days) improve in-hospital mortality in adults with definite infective endocarditis?
Cohort (n=100)
No
Does the timing of surgery (<7 days, 7-14 days, or >14 days) improve in-hospital mortality in adults with definite infective endocarditis?
Surgery for infective endocarditis performed 7 to 14 days after admission was associated with the lowest observed in-hospital mortality, though these exploratory findings were not statistically significant.
No significant mortality difference by surgery timing in small cohort; leaves open optimal intervention window.
Introduction: Infective endocarditis (IE) remains associated with high mortality, and the optimal timing of surgery in patients without an urgent indication remains uncertain. We evaluated the association between surgical timing, in-hospital mortality, and a study-specific ECHO risk score. Methods: We retrospectively studied 100 adults with definite IE treated at a tertiary care center in Bucharest, Romania. The ECHO score incorporated etiology, blood culture time to positivity, vegetation size, and embolization or surgical indication. Surgical timing was categorized as < 7 days, 7–14 days, or >14 days after hospital admission. The primary outcome was in-hospital mortality. Results: Eighty-two patients had a surgical indication, and 60 underwent surgery. Mortality was lowest after surgery at 7–14 days (23.1%), compared with >14 days (27.3%), no surgery despite indication (36.4%), and < 7 days (56.0%) (p = 0.123). Among patients with a non-urgent surgical indication, intermediate-risk patients had the lowest mortality after surgery at 7–14 days (25%), whereas no deaths occurred among surgically treated high-risk patients. ECHO risk category was not associated with mortality (p = 0.165). Conclusions: Surgery at 7–14 days was associated with the lowest observed mortality. These exploratory findings require confirmation in larger prospective studies.
No takes yet. Share an insight, caveat, or question.
Radu et al. (2026) conducted a cohort in Infective endocarditis (n=100). Surgical timing (7-14 days) vs. Surgery at <7 days, >14 days, or no surgery was evaluated on In-hospital mortality (p=0.123). Surgical timing at 7-14 days for infective endocarditis had the lowest in-hospital mortality (23.1%) versus >14 days (27.3%), <7 days (56.0%), and no surgery (36.4%) (p=0.123).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: