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Publications

Journal Article Ahead of print

PubMed: 41641982 DOI: 10.4274/tjtcs.2025.28395

The role of clinical frailty in predicting mortality following surgery for infective endocarditis.

Turk Gogus Kalp Damar Cerrahisi Derg

Authors: Özer Kandemir, Murat Koç, Kaan Kaya, Ufuk Mungan, Dilek Karamanlıoğlu, Hatice Tolunay, İbrahim Duvan, Erşah Doğramacı, Ferit Çiçekçioğlu

Affiliations

  • Department of Cardiovascular Surgery, University of Health Sciences Türkiye, Ankara Etlik City Hospital, Ankara, Türkiye.
  • Department of Infectious Diseases, University of Health Sciences Türkiye, Ankara Etlik City Hospital, Ankara, Türkiye.
  • Department of Cardiology, University of Health Sciences Türkiye, Ankara Etlik City Hospital, Ankara, Türkiye.

Abstract

BACKGROUND

Infective endocarditis continues to pose a significant challenge in cardiovascular surgery, with high morbidity and mortality rates despite advancements in diagnosis and treatment. This study aimed to identify predictors of in-hospital mortality among patients undergoing surgical intervention for active infective endocarditis, with a particular focus on frailty.

METHODS

A retrospective analysis was conducted on fifty-five consecutive patients who underwent surgery for active infective endocarditis between October 2022 and April 2025. Clinical variables, operative data, and outcomes were also collected. Frailty was assessed using the clinical frailty scale. Univariate and multivariate logistic regression analyses were performed.

RESULTS

The in-hospital mortality rate was 25.5%. Patients who did not survive were significantly older (median age 65.7 vs. 56.2 years) and had higher clinical frailty scale scores (mean 7.1 vs. 5.4) than those who survived. Frailty emerged as the sole independent predictor of mortality (odds ratio =3.41; 95% confidence interval: 1.20-9.65; p=0.021).

CONCLUSION

Frailty is a key predictor of early mortality in patients with surgical infective endocarditis. Preoperative frailty assessment and targeted interventions may enhance outcomes in this high-risk population.

MeSH

Mortality, Risk Assessment, Hospital Mortality, Endocarditis, Cardiac Surgical Procedures, Frailty