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00925njm 22002777a 4500 dc Ramos-Martinez, Antonio author Calderon-Parra, Jorge author Miró, José María author Munoz, Patricia author Rodriguez-Abella, Hugo author Valerio, Maricela author de Alarcón, Arístides author Luque, Rafael author Ambrosioni, Juan author Fariñas, María Carmen author Goenaga, Miguel Ángel author Oteo, Jose Antonio author Martinez Marcos, Francisco Javier author Vinuesa, David author Dominguez, Fernando author Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) author 2019-05-01 Aim: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. Methods and results: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. Conclusions: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention. (c) 2019 Elsevier B.V. All rights reserved. Ramos-Martinez Antonio, Calderon-Parra Jorge, Ma Miro Jose, Muñoz Patricia, Rodriguez-Abella Hugo, Valerio Maricela, et al. Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention. Int J Cardiol. 2019 May 01;282:24-30. Epub 2019 Jan 10. 10.1016/j.ijcard.2019.01.014 1874-1754 0167-5273 International Journal of Cardiology http://hdl.handle.net/20.500.13003/17342 30718134 L2001522479 2-s2.0-85060892633 https://hdl.handle.net/20.500.12105/22699 460380800005 Endocarditis Mortality Heart failure Embolism Bacteremia Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention