Objective Endocarditis as a potentially life-threatening disease with high complication and mortality rates. In recent years, an increase in the incident of endocarditis has been reported throughout Europe. In the aging society, successful treatment is complex and challenging owing to the high rate of multimorbidity.

Methods We initiated a statewide prospective multicenter endocarditis registry in 2020. Perioperative risk factors, comorbidities, microbiological, laboratory and imaging diagnostics, complications, and mortality including 1-year follow-up were collected. The present midterm analysis includes factors influencing mortality in the first 313 patients.

Result In-hospital mortality and 1-year mortality were 28.4 and 40.9%, respectively. Preoperative risk factors include age (p < 0.001), EuroSCORE II (p < 0.001), coronary artery disease (p = 0.022), pacemaker probe infection (p = 0.033), preoperative left ventricular ejection fraction (LVEF), systemic inflammatory response syndrome (SIRS), pulmonary edema, heart failure, septic emboli, acute renal failure, impaired coagulation, hypalbuminemia (p < 0.001), and N-terminal prohormone of brain natriuretic peptide (NTproBNP) (p = 0.001). The presence of peri-annular abscess, perforation, and shunt were associated with increased mortality (p = 0.004, 0.001, and 0.004, respectively). In addition, cardiopulmonary bypass time influenced mortality (p = 0.002). The main postoperative causes of death were multi-organ failure, renal failure, vasoplegia, and low-output syndrome (p < 0.001). Previous endocarditis was 7.7%, while 35.5% were prosthetic valve recipients and 33.6% were redo surgeries.

Conclusion Our first registry data show the complexity of endocarditis patients and the challenging treatment. Some risk factors can be treated preoperatively. For instance, hypalbuminemia and the duration of the procedure can be controlled with adequate albumin substitution and carefully planned procedures restricted to the essential requirements, that is, hybrid approaches with consecutive interventions.

目的 心内膜炎是一种潜在危及生命的疾病，具有高并发症和死亡率。近年来，整个欧洲心内膜炎的发病率有所增加。在老龄化社会，由于多种疾病的发病率很高，成功的治疗是复杂且具有挑战性的。

方法 我们于 2020 年启动了全州前瞻性多中心心内膜炎登记。收集围手术期危险因素、合并症、微生物、实验室和影像诊断、并发症和死亡率，包括 1 年随访。目前的中期分析包括影响前 313 名患者死亡率的因素。

结果 院内死亡率和1年死亡率分别为28.4%和40.9%。术前危险因素包括年龄 ( p  < 0.001)、EuroSCORE II ( p  < 0.001)、冠状动脉疾病 ( p  = 0.022)、起搏器探头感染 ( p  = 0.033)、术前左心室射血分数 (LVEF)、全身炎症反应综合征(SIRS)、肺水肿、心力衰竭、脓毒性栓塞、急性肾功能衰竭、凝血功能受损、低白蛋白血症 ( p  < 0.001) 和脑钠肽 N 末端激素原 (NTproBNP) ( p  = 0.001)。瓣环周围脓肿、穿孔和分流的存在与死亡率增加相关（分别为p  = 0.004、0.001 和 0.004）。此外，体外循环时间影响死亡率（p  = 0.002）。术后死亡的主要原因是多器官衰竭、肾功能衰竭、血管麻痹和低输出综合征（p  < 0.001）。既往患有心内膜炎的比例为 7.7%，其中 35.5% 为人工瓣膜接受者，33.6% 为重做手术。

结论 我们的第一份登记数据显示了心内膜炎患者的复杂性和治疗的挑战性。一些危险因素可以在术前进行治疗。例如，低白蛋白血症和手术持续时间可以通过足够的白蛋白替代和精心计划的仅限于基本要求的程序（即连续干预的混合方法）来控制。