Evolution of Prognosis in Left-Sided Infective Endocarditis: A Propensity Score Analysis of 2 Decades

According to the multivariate analysis, the independent predictors of in-hospital mortality in the first period were age (odds ratio [OR]: 1.275; 95% confidence interval [CI]: 1.015 to 1.602), S. aureus infection (OR: 2.419; 95% CI: 1.105 to 5.292), vegetations on echocardiography (OR: 3.542; 95% CI: 1.343 to 9.343), persistent infection (OR: 2.343; 95% CI: 1.217 to 4.512), heart failure (OR: 3.110; 95% CI: 1.573 to 6.148), and renal failure (OR: 2.009; 95% CI: 1.068 to 3.779) whereas viridans streptococci infection was protective (OR: 0.316; 95% CI: 0.101 to 0.985). According to the model, expected in-hospital mortality for the second period was 32.2% (95% CI: 29.8% to 34.7%), while observed in-hospital mortality was 28.1% (12.5% reduction). [...]observed in-hospital mortality rate in patients with LSIE was lower than expected if we consider the worse profile of the patients over time; this implies a general improvement in management in the past 20 years. 1997–2002 (n = 259) 2003–2008 (n = 335) 2009–2014 (n = 375) p Value OR (95% CI) Men 170 (66) 211 (63) 247 (66) 0.878 Age, yrs 59.1 ± 14.9 63.9 ± 14.3 66.9 ± 13.5