A Comprehensive Evaluation of Clinical Variables and Their Association with in Hospital Mortality in Infective Endocarditis Cases
Yeliz Güler1
, Yelda Saltan Özateş1, Hüseyin Akgün1, Şevval Tekin1, İhsan Demirtaş1, Gazi Capar1, Ufuk Sali Halil1, Mehmed Yanartaş2, Ahmet Güler1, Cevat Kırma3
1Department of Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
2Department of Cardiovascular Surgery, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
3Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, İstanbul, Türkiye
Keywords: Barcelona bio-heart failure risk score; infective endocarditis; mortality.
Abstract
Objectives: Infective endocarditis (IE) remains a significant clinical challenge due to its high morbidity and mortality rates. Prognosis is influenced by patient characteristics, causative microorganisms, complications, and echocardiographic findings. The Barcelona Bio-Heart Failure (BCN Bio-HF) Risk Score, widely used in heart failure, has not yet been evaluated in IE. This study aimed to assess the association between the BCN score and in-hospital mortality in patients with IE.
Methods: This retrospective, single-center observational study included 108 patients diagnosed with IE. Patients were divided into two groups based on the occurrence of in-hospital mortality, which was defined as any death occurring during hospitalization. Clinical, demographic, laboratory, and echocardiographic data were compared between the groups.
Results: Among 108 patients, 29 (26.9%) experienced in-hospital mortality. Compared to survivors, non-survivors were older (p=0.046) and had a higher prevalence of chronic kidney disease (p=0.041). Staphylococcus aureus and methicillin-resistant strains were more common in the mortality group (p=0.043 and p=0.04, respectively). Echocardiographic findings showed a lower ejection fraction (p=0.03), higher pulmonary artery systolic pressure (p=0.017), and larger vegetation size (p=0.033) in non-survivors. Mechanical complications were also more frequent (p=0.017). Laboratory results revealed lower hemoglobin (p=0.012) and higher levels of WBC (p=0.035), CRP (p=0.01), procalcitonin (p=0.02), NT-proBNP (p=0.008), and BCN Bio-HF risk score (p=0.008) in patients with in-hospital mortality.
Conclusion: The BCN Bio-HF risk score showed potential in predicting in-hospital mortality in infective endocarditis by integrating clinical and biomarker data. Future studies should aim to develop IE-specific prognostic models incorporating dynamic clinical variables and novel biomarkers to enhance risk stratification and guide management.
Cite This Article: Güler Y, Saltan Özateş Y, Akgün H, Tekin Ş, Demirtaş İ, Capar G, et al. A Comprehensive Evaluation of Clinical Variables and Their Association with In Hospital Mortality in Infective Endocarditis Cases. Koşuyolu Heart J 2025;28(2):72–78