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.