Prognosis

There are no comprehensive studies that have looked at overall prognosis in patients with IE. Left-sided IE tends to have a poorer prognosis, with higher morbidity and mortality than right-sided IE.[6][7]​ Heart failure remains the single greatest predictor of prognosis in patients, regardless of the offending microorganism. Other indicators of mortality include cerebral complications, vegetation length >10 mm, moderate to severe heart failure, bacterial aetiology other than Viridans streptococci and failure to undertake surgery when indicated.[20][135] Surgery, if indicated, has been associated with a lower overall mortality; however, patients with definitive indications for surgery tend to be critically ill and carry a high intra-operative mortality rate.[20][136]

As the population ages, IE is becoming more frequently seen, with trends towards worsening outcomes.[62] Mortality of IE in older patients is higher than in younger patients: age, cerebral embolism, and prosthetic valve endocarditis have been shown to be risk factors for the observed increase in mortality.

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