Abstract
BACKGROUND: Infective endocarditis (IE) is a severe disease associated with high in-hospital mortality. Prognostic factors and the independent role of cardiac surgery remain unclear in clinical practice in Vietnam. OBJECTIVE: To identify factors associated with in-hospital mortality in IE patients and evaluate the independent role of cardiac surgery. METHODS: This retrospective descriptive-analytical study included 129 patients diagnosed with IE at the University Medical Center Ho Chi Minh City from January 2019 to April 2024. Clinical, laboratory, treatment, and outcome data were collected. Logistic regression analyses were performed to identify mortality predictors. RESULTS: The in-hospital mortality rate was 16.3%. Univariate analysis identified hepatic failure, septic shock, ventilator-associated pneumonia, disseminated intravascular coagulation (DIC), and absence of surgery as associated factors. In multivariate analysis, septic shock (OR = 22.0; 95% CI: 7.1-68.5) and not undergoing cardiac surgery (OR = 0.07; 95% CI: 0.01-0.43) were independent predictors. CONCLUSION: In-hospital mortality in IE remains high. Early identification of high-risk patients and improved access to indicated cardiac surgery may enhance prognosis.