Impacts of blood culture-negative status on outcomes of infectious endocarditis patients with nonsurgical and surgical intervention.

This study aims to clarify impacts of blood culture-negative on results of infectious endocarditis (IE) patients with nonsurgical and surgical intervention. This retrospective study was done to investigate patients with IE during study period at our hospital. There were 720 blood culture-negative endocarditis patients (35.7%). In-hospital mortality, aortic regurgitation ≥ 4 cm2, mitral regurgitation (MR) ≥ 4 cm2, vegetation size ≥ 10 mm, time between symptoms and admission ≥ 2 months, mechanical ventilation length, rate of surgical patients, and acute kidney injury postoperative in blood culture-negative group were significantly higher than those in blood culture-positive group. Time between symptoms and admission ≥ 2 months, vegetation size ≥ 10 mm, aortic regurgitation ≥ 4 cm2, MR ≥ 4 cm2 vegetations on aortic valve, and vegetations of congenital heart disease were found to be related to blood culture-negative. Univariate and multivariate analysis indicated that blood culture-negative is statistically significantly related to in-hospital mortality, aortic regurgitation ≥ 4 cm2, MR ≥ 4 cm2, vegetation size ≥ 10 mm, and mechanical ventilation length ≥ 72 hours, respectively. In our investigation, blood culture-negative status is associated with higher in-hospital mortality and more clinical complications including aortic regurgitation ≥ 4 cm2, MR ≥ 4 cm2, vegetation size ≥ 10 mm, and mechanical ventilation length ≥ 72 hours in IE.