Journal of Clinical Medicine
Contemporary Clinical Spectrum and Factors Associated with Mortality in Infective Endocarditis: A Multicenter Cohort Study (COSMO-IE)
By Mehmet Kış, Oktay Şenöz, Duygu İnan and 22 others.
Abstract
Background
Despite continuous advancements in diagnostic imaging and targeted antimicrobial protocols for infective endocarditis (IE), global epidemiological data show that both disease burden and incidence continue to rise. This study aimed to evaluate real-world diagnostic and treatment approaches in accordance with the 2023 European Society of Cardiology (ESC) IE Guidelines and to identify independent predictors of mortality in a contemporary patient cohort.
Methods
This multicenter, retrospective cohort study analyzed data from 470 consecutive adult patients diagnosed with IE across 27 academic reference centers between 1 September 2023 and 1 June 2025. Patients were managed and adjudicated according to the 2023 ESC diagnostic criteria. Demographic data, clinical characteristics, microbiological profiles, imaging findings, empirical antibiotic therapy patterns, and clinical outcomes were analyzed. Independent predictors of mortality were determined using multivariable Cox proportional hazards regression models.