{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T15:39:30Z","timestamp":1774366770914,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infective endocarditis (IE) is a morbid condition with high mortality. We investigated predictors of in\u2010hospital mortality and embolic phenomena in a contemporary Australasian cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified all patients with IE admitted between January 2017 and 30th April 2020 (40\u2009months). Patient characteristics, risk factors and clinical outcomes were retrospectively collected and analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and seventy\u2010two consecutive patients (mean age: 56.8\u00a0\u00b1\u200917.9\u2009years, male: 63%, 114\/172) were included. Causative organisms were <jats:italic>Staphylococcus aureus<\/jats:italic> (44%, 75\/172), <jats:italic>Enterococcus faecalis<\/jats:italic> (15%, 26\/172), <jats:italic>Streptococcus mitis<\/jats:italic> (6%, 10\/172) and <jats:italic>Staphylococcus epidermidis<\/jats:italic> (3%, 6\/172). In\u2010hospital mortality was 15% (25\/172). Embolic complications were found among 57% (98\/172) of patients, the most common being stroke (23%, 40\/172), septic pulmonary emboli (17%, 29\/172), splenic and\/or renal emboli (17%, 26\/172) and peripheral limb emboli (15%, 25\/172). Sixty (35%, 60\/172) patients underwent cardiac surgery. On multivariable analysis, independent predictors of in\u2010hospital mortality were: increased age (odds ratio: 1.064, per year older, <jats:italic>P<\/jats:italic>\u00a0=\u20090.001), ICU admission independent of cardiac surgery (OR 9.81, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), moderate or severe LV impairment (OR 5.19, <jats:italic>P<\/jats:italic>\u00a0=\u20090.012) and any sign of embolic phenomena to limbs (OR 5.02, <jats:italic>P<\/jats:italic>\u00a0=\u20090.006). Multivariable predictors of embolic complications were <jats:italic>S. aureus<\/jats:italic> bacteraemia (OR 3.22, <jats:italic>P<\/jats:italic>\u00a0=\u20090.001) and large vegetation &gt;10\u2009mm (OR 3.04, <jats:italic>P<\/jats:italic>\u00a0=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We demonstrate predictors of in\u2010hospital mortality and embolic phenomena in our cohort. Though age remains a consistent predictor of mortality, surprisingly, signs of embolic phenomena to the limbs was established as an independent predictor of mortality. The mechanism of this is unclear and warrants further evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17907","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T12:49:11Z","timestamp":1659012551000},"page":"2312-2317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Embolic phenomena to the limbs are an independent predictor of in\u2010hospital mortality from infective endocarditis"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7778-4657","authenticated-orcid":false,"given":"Thomas","family":"Lovelock","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4724-008X","authenticated-orcid":false,"given":"Michael Z. L.","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayushica","family":"Saran","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thodur","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2000400"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1206782"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.15.1933"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.8653"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000124719.61827.7F"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.029"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.114.003397"},{"key":"e_1_2_8_9_1","first-page":"A4192","article-title":"Serious complications after infective endocarditis","volume":"57","author":"Le V","year":"2010","journal-title":"Dan. 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