• Stefano Urso, María Ángeles Tena, Miguel González-Barbeito, Federico Paredes, Verónica Quevedo, Francisco Portela, and EME study group.
• Cardiac Surgery Department, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain. Electronic address: stefano_urso@inwind.it.
• Med Clin (Barc). 2020 Jul 24; 155 (2): 63-67.

ObjectivesWe aimed to explore the impact of the time interval between symptoms and diagnosis on post-operative infective endocarditis (IE) survival.MethodsFrom 2014 to 2019, data from 93 consecutive patients undergoing cardiac surgery due to left-sided±right-sided IE were prospectively recorded in our specific electronic database. Patients were classified into 2 groups according to time interval between first clinical symptoms and definitive endocarditis diagnosis: patients with early diagnosis (≤8 days) and patients with late diagnosis (>8 days). Follow-up was 100% complete, and follow-up mean time was 471 days.ResultsAmong the 93 patients undergoing cardiac surgery due to definite left-sided IE, 48 (51.6%) had early-diagnosed IE whereas 45 (48.4%) presented with a late-diagnosed IE. Unadjusted and propensity score adjusted mid-term survival Kaplan-Meier analysis showed significantly worse survival of patients belonging to the early-diagnosis group (p .019 and .049 respectively). Multivariable Cox regression analysis identified only one predictor of mid-term mortality: EuroSCORE II (Hazard ratio 1.03, 95% CI 1.01-1.05, p .0008).ConclusionThe association in the Kaplan-Meier analysis between "early-diagnosis group" and mortality suggests that this group of patients presents clinical characteristics of severity that, on the one hand, speed up the diagnostic process and on the other, converge in the determination of a higher euroSCORE II value, which is the only independent predictor of mid-term mortality according to our analysis.Copyright © 2020 Elsevier España, S.L.U. All rights reserved.

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