Krajinovic V, et al. - The impacts of cardiac surgery (CS) on the outcome of patients with infective endocarditis (IE) in different stages of sepsis severity were determined. The presence of sepsis or septic shock as defined in Sepsis-3 definitions was found to be related to unfavorable outcomes in patients with IE. A positive influence of surgical treatment on outcomes (in-hospital mortality and 1-year survival) was seen in patients with IE and sepsis or septic shock.

Methods

• Between 2000 and 2011, 294 patients with definite IE native or prosthetic valve IE were admitted.
• Using multivariable logistic regression and prospective assessment, researchers assessed clinical characteristics and outcomes (in-hospital and 1-year mortality) in surgically and medically treated patients stratified by severity of sepsis and using new Sepsis-3 definitions.

Results

• After adjusting for other risk factors of poor outcomes (neurological complications, congestive heart failure, and Staphylococcus aureus IE), researchers found that the presence of sepsis or septic shock during IE demonstrated a statistical link with increased in-hospital mortality (odds ratio [OR] 8.915, P < 0.001 and OR 35.969, P < 0.001, respectively).
• In patients with sepsis or septic shock and IE , a positive impact of surgical treatment on in-hospital mortality (OR 5.157, P < 0.001) as well as on 1-year survival (hazard ratio 3.092, P < 0.001) was noted.