Predictors of in-hospital mortality in surgically treated valvular infective endocarditis cases at National Heart Institute, Egypt

Background: The aim of this study was to review the surgical experience in the cardiothoracic surgical department, National Heart Institute (NHI), Egypt regarding patients with native or prosthetic valve endocarditis and determining predictors of mortality. Methods: A prospective study of fifty consecutive patients diagnosed with definite infective endocarditis (IE) and underwent cardiac surgery from September 2012 till September 2014 were included. We tested preoperative, intraoperative, and postoperative data as potential predictors of mortality. Results: Rheumatic heart disease was the most common underlying cardiac disease (n = 27, 54%). Native valve endocarditis was present in 37 (74%) and prosthetic valve endocarditis in 13 (26%). Mean EuroSCORE II was 5.71%. The in-hospital mortality was 20%. Congestive heart failure (P = 0.014), embolization (P = 0.011), and periannular extension of infection (P = 0.029) were independent predictors of in-hospital mortality. According to the ROC curve, EuroSCORE II > 5.93% was associated with the best predictive value for in-hospital mortality (AUC: 0.813). In the group of patients selected for valve repair strategy, only one mortality (11%) was recorded and no recurrence occurred. Conclusions: Surgery for IE continues to be challenging. EuroSCORE II has a good discrimination ability to predict in-hospital mortality in IE surgery. Satisfactory results can be obtained with valve repair in IE