What question did this study set out to answer?

This research aims to identify clinical characteristics and complications linked to mortality in patients with infective endocarditis.

May 14, 2026

Early diagnosis of infective endocarditis and prognostic implications

Key Points

This research aims to identify clinical characteristics and complications linked to mortality in patients with infective endocarditis.
Conducted a retrospective cohort study involving patients with confirmed infective endocarditis from 2016 to 2024.
Analyzed clinical characteristics, diagnostic delays, complications, and in-hospital mortality.
Utilized univariate and multivariate statistical analyses, including logistic regression.
Among 234 patients, overall mortality was 29.1%.
Older age (67 vs 56 years, p < 0.001) and shock (OR 3.24; 95% CI 1.72–6.09; p < 0.001) were significant mortality predictors.
Diagnostic delays greater than 4 days correlated with increased mortality (OR 1.86; 95% CI 1.03–3.36; p = 0.039).

Abstract

Abstract Introduction Infective endocarditis (IE) is a potentially life-threatening infection. Identifying risk factors associated with mortality is essential to optimize management. This study analyzes the clinical characteristics and complications associated with mortality in a cohort of IE patients between 2016 and 2024. Methods A retrospective cohort study was conducted including patients with confirmed IE between 2016 and 2024. Clinical characteristics, complications, diagnostic and therapeutic delays (from symptom onset and from hospital admission), and other factors related to in-hospital mortality were analyzed. Statistical analysis included univariate (chi-square and Mann–Whitney tests) and multivariate (logistic regression) analyses. Results Among 234 included patients, overall mortality was 29.1%. Deceased patients were older (67 vs 56 years, p 0.001), had a higher prevalence of prosthetic valve endocarditis (30% vs 12%, p = 0.002), and underwent surgery less frequently (28% vs 65%, p 0.001). Complications such as shock (p 0.001) and atrioventricular block (p = 0.040) were associated with increased mortality. A longer delay from symptom onset to diagnosis was associated with lower mortality (p = 0.001), whereas a longer delay from hospital admission to diagnosis correlated with higher mortality (p = 0.032). These findings suggest that cases diagnosed rapidly after symptom onset often present a more aggressive course, while diagnostic delay after admission may reflect under-recognition or suboptimal management. In multivariate analysis, independent predictors of mortality were age (OR 1.05; 95% CI 1.02–1.08; p = 0.003), shock (OR 3.24; 95% CI 1.72–6.09; p 0.001), previous heart disease (OR 2.11; 95% CI 1.21–3.68; p = 0.008), and diagnostic delay 4 days (OR 1.86; 95% CI 1.03–3.36; p = 0.039). Tables summarizing univariate and multivariate mortality analyses are provided. CONCLUSIONS Mortality in infective endocarditis is significantly associated with older age, shock, pre-existing heart disease, and lack of surgery. A subacute clinical course and diagnostic delay were also key factors linked to worse outcomes.

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