{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:30:27Z","timestamp":1760146227400,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German \u200bResearch Foundation","award":["491454339"],"award-info":[{"award-number":["491454339"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Objective: to investigate how body mass index (BMI) affects the outcome in patients treated surgically for infective endocarditis (IE). Methods: This is a single-center observational analysis of consecutive patients treated surgically for IE. We divided the cohort into six groups, according to the WHO classification of BMI, and performed subsequent outcome analysis. Results: The patient population consisted of 17 (2.6%) underweight, 249 (38.3%) normal weight, 252 (38.8%) overweight, 83 (12.8%) class I obese, 28 (4.3%) class II obese, and 21 (3.8%) class III, or morbidly obese, patients. The median age of the entire cohort was 64.5 [52.5\u201373.6] years. While only 168 (25.9%) patients were female, women significantly more often exhibited extremes in regards to BMI, including underweight (47.1%) and morbid obesity (52.4%), p = 0.026. Class II and III obese patients displayed more postoperative acute kidney injury (47.9%), p = 0.003, more sternal wound infection (12.9%), p &lt; 0.001, worse 30-day survival (20.4%), p = 0.031, and worse long-term survival, p = 0.026, compared to the results for the other groups. However, the multivariable analysis did not identify obesity as an independent risk factor for 30-day mortality, with an odds ratio of 1.257 [0.613\u20132.579], p = 0.533. Rather, age &gt; 60, reduced LVEF &lt; 30%, staphylococcal infection, and prosthetic valve endocarditis correlated with mortality. While BMI showed poor discrimination in predicting 30-day mortality on the ROC curve (AUC = 0.609), it showed a fair degree of discrimination in predicting sternal wound infection (AUC = 0.723). Conclusions: Obesity was associated with increased comorbidities, complications, and higher postoperative mortality in IE patients, but it is not an independent mortality risk factor. While BMI is a poor predictor of death, it is a good predictor of sternal wound infections.<\/jats:p>","DOI":"10.3390\/jcdd11100327","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T04:45:35Z","timestamp":1729485935000},"page":"327","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Weight\u2019s Role in Infective Endocarditis Surgery"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6859-5384","authenticated-orcid":false,"given":"Ahmed","family":"Elderia","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerold","family":"Woll","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Maria","family":"Wallau","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid","family":"Bennour","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6568-6766","authenticated-orcid":false,"given":"Stephen","family":"Gerfer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-8626","authenticated-orcid":false,"given":"Ilija","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Wahlers","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-5549","authenticated-orcid":false,"given":"Carolyn","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Center, University of Cologne, Kerpener Stra\u00dfe 62, 50937 Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.echo.2016.02.010","article-title":"Infective endocarditis: A deadly disease if diagnosed too late","volume":"29","author":"Habib","year":"2016","journal-title":"J. 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