Introduction
Despite substantial improvements in diagnostic accuracy, medical therapy
and surgical techniques, infective endocarditis (IE) remains a
high-lethality disease, with an incidence that has not changed in the
last two decades 1.
Several studies have evaluated IE epidemiological characteristics and
morbimortality data in developed countries. Nonetheless, significant
differences in epidemiological and microbiological aspects are evident
when developed and developing countries are compared2-3. In the setting of developing countries, EI
epidemiological studies remain scarce, even known that these data would
contribute to IE prevention, diagnosis, and treatment.
A particularly debated issue in IE management is the best time to
indicate an intervention since about 30% of patients will be submitted
to a cardiac surgery 4. Historically, it was sought to
avoid surgery during the active phase, due to high postoperative
mortality and valve dysfunction risk 5. However, a new
trend is performing earlier operations. Kang et al., for instance,
demonstrated that surgery performed within the first 48 hours was
associated with a significant reduction in in-hospital mortality and
6-weeks embolic events compared to surgery at any hospitalization time
(3% vs. 23%) 6.
Based on these aspects, the present study aims to describe IE
epidemiological, clinical and microbiological profiles in a tertiary
university center in South America, in order to identify in-hospital
mortality predictors and to compare patient’s outcomes, based on whether
or not they have undergone cardiac surgery.