Background: Infective endocarditis (IE) is an infrequent, but serious disease with high mortality.

Objective: To evaluate the factors predicting the in-hospital mortality in patients with IE and to determine the association between factors and microorganisms.

Materials and Methods: The medical records of adult patients diagnosed with IE by modified Duke’s criteria at Siriraj Hospital, the largest tertiary referral center and medical school in Thailand, between December 2014 and April 2020 were retrospectively reviewed.

Results: One hundred thirty-nine patients with IE were included with an average age of 54.4±15.9 years and 62.6% were male. Native valve endocarditis (NVE) was diagnosed in 77.3%. The three most common pathogens were Streptococcus spp. at 50.4%, culture negative IE at 16.5%, and Staphylococcus aureus at 12.2%. Streptococcus spp. was the more common in NVE (p=0.017) and mitral valve IE (p=0.042). Heart failure and embolic stroke occurred in 43.9% and 12.2% of patients, respectively. Valve surgery was performed on 63 patients. Aortic, mitral, and multi-valve involvements of IE were reported in 53.3%, 49.6%, and 10.1%, respectively. Valvular complications were detected in 40.3%, which were perforation, pseudoaneurysm, and perivalvular abscess in 30.2%, 8.6%, and 7.9%, respectively. The in-hospital mortality rate was 19.4% and significantly higher in older age (adjusted odd ratio [aOR] 1.05, 95% confidence interval [CI] 1.003 to 1.11), renal insufficiency (aOR 21.37, 95% CI 3.95 to 115.57) and higher pulmonary artery systolic pressure (aOR 1.008, 95% CI 1.03 to 1.13).

Conclusion: IE remains a serious disease with high mortality. The predictors of in-hospital mortality in patients with IE were age, renal insufficiency, and high pulmonary artery systolic pressure.

Received 1 October 2023 | Revised 20 March 2024 | Accepted 21 March 2024

DOI: 10.35755/jmedassocthai.2024.4.13971