The Usual Suspects' but Always Ignored: The Nutritional and Immune System's Status Affect the Infective Endocarditis Hospital Mortality

Abstract

The therapy of Infective Endocarditis is a very long and difficult. There are many factors that affected the management of therapy. Among them, maybe the most ignored factor belongs to the patient's' immune-nutrition status. Even though this assessment is more complicated; in recent years, prognostic nutritional index (PNI) was an established that inflammation-based nutritional score and the lymphocyte to-CRP ratio (LCR) was accepted as a marker of immune-inflammation's marker. Our study is aimed to investigate the relationship between LCR and PNI values and in-hospital mortality. Our comprehensive tertiary cardiology hospital in Turkey was included in this observational study, 36 patients with definite infective endocarditis were enrolled. We calculated LCR and PNI index from blood samples results of first hospitalization day. P-value < 0.05 was considered as statistically significant. In hospital mortality occurred in 12 (33%). LCR index was significantly lower in hospital mortality group (p=0.04) PNI index was also lower in hospital mortality group but it was not significant. The nutritional and immune system's status of the patient at the beginning of the treatment determines the hospital mortality of the patient during challenging treatment. In this context, the assessment of the PNI index and lymphocyte to-CRP ratio could aid physicians in determining hospital mortality risk and could affect the management of infective endocarditis patients.