{
  "abstract": "Background Staphylococcus aureus infective endocarditis (SA-IE) remains a serious condition, with in-hospital mortality rates ranging between 30% and 40%. While current guidelines suggest surgery may be considered in all SA-IE cases, robust data comparing outcomes between patients undergoing surgery and those receiving medical therapy alone are scarce.Methods Using the NatIonal Danish endocarditis stUdieS registry, we identified all patients with left-sided SA-IE between 2016 and 2021. Patients were categorised into two groups: surgical and non-surgical. Baseline characteristics were assessed, and in-hospital mortality was analysed using crude estimates and multivariable Cox regression.Results Of 918 patients identified, 160 (17%) patients underwent surgery (median age 63.7 years; 73% male), and 758 (83%) were treated non-surgically (median age 75.0 years; 58% male). Surgical patients had fewer comorbidities, including diabetes (18% vs 27%) and congestive heart failure (6% vs 19%). Surgical patients presented at admission with more severe conditions, including larger vegetations (56% vs 21%), sepsis (53% vs 33%) and emboli (24% vs 10%). Crude in-hospital mortality was lower in the surgical group (17% vs 28%), as was 1 year mortality (21% vs 45%). After adjusting for confounders, there was no significant difference in adjusted in-hospital mortality between the groups (HR 0.75 (95% CI 0.47 to 1.19)); however, 1-year mortality was statistically significantly lower in surgical patients (HR 0.61 (95% CI 0.41 to 0.91)).Conclusion In patients with SA-IE, surgical patients were younger and had fewer comorbidities, but had more severe disease status at admission, compared with non-surgical patients. Surgery was associated with lower 1-year mortality, but the heterogeneity of this patient population limits firm conclusions about the superiority of either treatment strategy.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Sikander Tajik Nielsen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Peter Laursen Graversen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Katra Hadji-Turdeghal"
    },
    {
      "affiliations": [
        "Department of Cardiology, Odense University Hospital, Odense, Region of Southern Denmark, Denmark",
        "Faculty of Health Sciences, University of Southern Denmark, Odense, Region of Southern Denmark, Denmark"
      ],
      "name": "Jacob Eifer Moller"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Region Zealand, Denmark",
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Niels Eske Bruun"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Andreas Dalsgaard Jensen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Jeppe K Petersen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Central Denmark Region, Denmark"
      ],
      "name": "Jonas Agerlund Povlsen"
    },
    {
      "affiliations": [
        "Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Immunology and Microbiology, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Claus Moser"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Morten Smerup"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark"
      ],
      "name": "Hanne Sortsøe Jensen"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Daniel Faurholt-Jepsen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark",
        "Department of Clinical Medicine, Aalborg University, Aalborg, North Denmark Region, Denmark"
      ],
      "name": "Peter Søgaard"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Jannik Helweg-Larsen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Henning Bundgaard"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Emergency Medicine, Herlev Hospital, Herlev, Capital Region of Denmark, Denmark"
      ],
      "name": "Kasper Iversen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Cardiology, Bispebjerg Hospital, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Lauge Østergaard"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Lars Køber"
    },
    {
      "affiliations": [
        "Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Capital Region of Denmark, Denmark",
        "Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Capital Region of Denmark, Denmark"
      ],
      "name": "Emil Loldrup Fosbøl"
    }
  ],
  "title": "Patient characteristics, valve surgery and 1-year mortality in left-sided Staphylococcus aureus infective endocarditis: a nationwide study",
  "uid": "99b14173-0c99-51be-923f-c3e045dbcefe"
}