Early versus Delayed Surgery for Infective Endocarditis: A Systematic Review and Meta-Analysis
Anantha-Narayanan M, et al., 2016 · 21 studies included
Summary
Meta-analysis of 21 studies evaluating >6,000 patients with left-sided infective endocarditis comparing early surgery (median <=7 days) versus delayed conventional management.
Conclusion
Early surgery was associated with a significant 40% reduction in all-cause mortality (OR 0.61, 95% CI 0.50–0.74, P < 0.001) and marked reduction in embolic events without increasing perioperative mortality in patients with heart failure, large vegetations, or uncontrolled infection.
Clinical Context & Relevant Topics (2)
Disease ReferenceCritical AS, acute AR/MR mechanics, prosthetic valve emergencies, and infective endocarditis with multidisciplinary surgical triggers.
Life-threatening organ dysfunction caused by a dysregulated host response to infection — recognized by an acute rise in SOFA score, not by infection plus fever alone.