524 Infective Endocarditis Timings and Indications for Intervention in Neurological Complications

Abstract

Abstract Background Infective endocarditis (IE) is the inflammation of the endocardium. Cardiac surgery is reserved for patients that deteriorate despite best medical therapy. Neurological complications are a serious IE complication. There is still not a clear consensus on how and when IE should be treated when neurological complications occur. Identifying in which patients to intervene and when can help improve patient management. Aim To evaluate the management and outcomes of patients that presented with IE in the Wessex region of England with a particular focus on treatment of patients with neurological complications. Method Patient records were accessed to collect data on patient demographics, infection status and clinical management of patients between 2019–2020. Results 147 patients with IE were included, 19 patients with neurological complications underwent early surgery (n=15) or late surgery (n=4). The mean ages were 54 (30–76) and 55 (22–82) respectively. There was no statistical association between timing of surgery, early (within 14 days of CT) or late, and mortality (p=0.53). The median stay in hospital for early and late surgery was 28 days and 47 days respectively. The only significant indicator for having early surgery was the presence of staph aureus (p=0.008). The 6-month survival for early and late surgery was 73.3% and 100% (p=0.212). Conclusions Early surgery was not shown to be significantly associated with 6-month mortality but did lead to earlier discharge from hospital. Neurological complications in endocarditis significantly affects survival. Due to the limited number of patients considered further data is needed to draw more conclusive results.