Long-term outcome of infective endocarditis: the impact of early surgical intervention

Clin Infect Dis. 2001 Nov 15;33(10):1636-43. doi: 10.1086/323785. Epub 2001 Oct 10.


To determine the impact of early surgical intervention on long-term survival in patients with infective endocarditis (IE), charts of all patients who had IE from January 1987 through December 1996 were reviewed. A total of 252 patients with definite or possible IE were included. Forty-four patients (17.5%) had early surgery on median hospital day 2 (range, 0-30 days), and 208 patients (82.5%) received medical treatment alone. On multivariate analysis, several variables, including early surgical intervention, improved long-term survival rates (hazard ratio, 1.5; P=.03), mainly in patients with Staphylococcus aureus etiology (P=.04). When patients with prosthetic devices were excluded, the median duration of survival for patients who had early surgery was >150 months, compared with 61.5 months for patients in the medical group (P=.1). Early surgical intervention compared with medical therapy alone is associated with increased short- and long-term survival rates in patients with IE, primarily when IE is caused by S. aureus.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / microbiology
  • Bacterial Infections / mortality*
  • Bacterial Infections / surgery*
  • Child
  • Child, Preschool
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / mortality*
  • Endocarditis, Bacterial / surgery*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Time Factors
  • Treatment Outcome