Contemporary Clinical Spectrum and Factors Associated with Mortality in Infective Endocarditis: A Multicenter Cohort Study (COSMO-IE)

@article{kıs2026contemporary,
  title = {{Contemporary Clinical Spectrum and Factors Associated with Mortality in Infective Endocarditis: A Multicenter Cohort Study (COSMO-IE)}},
  author = {Mehmet Kış and Oktay Şenöz and Duygu İnan and Onur Akhan and Esra Canbolat Ünlü and Özlem Güler and Tuba Tatlı Kış and Şemsi Nur Karabela and Duygu Çerçioğlu Özdemir and Süleyman Çağan Efe and Pınar Şen and Hatice Özdamar and Derya Seyman and Ayşe Batırel and Utku Zeybey and Çisem Oktay and Pelin Geyik Pekin and Selin Özdemir and Adem Köse and Kemalettin Özden and Oğuz Karabay and Şafak Kaya Kavak and Ali Mert and Sena Kaçan and Tuncay Güzel and Selda Aydın and Uğur Kostakoğlu and Seyit Ali Büyüktuna and Mesut Gitmez and Esma Kepenek Kurt and Fatma Zühre Alparslan Tanyeri and Veysi Can and Lütfü Bekar and Mehmet Çelik and Nazan Tuna and Şükran Köse and Mehmet Birhan Yılmaz},
  journal = {Journal of clinical medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15197760},
  url = {https://europepmc.org/article/PMC/PMC13666091},
  note = {CC BY},
}

TY  - JOUR
TI  - Contemporary Clinical Spectrum and Factors Associated with Mortality in Infective Endocarditis: A Multicenter Cohort Study (COSMO-IE)
AU  - Mehmet Kış
AU  - Oktay Şenöz
AU  - Duygu İnan
AU  - Onur Akhan
AU  - Esra Canbolat Ünlü
AU  - Özlem Güler
AU  - Tuba Tatlı Kış
AU  - Şemsi Nur Karabela
AU  - Duygu Çerçioğlu Özdemir
AU  - Süleyman Çağan Efe
AU  - Pınar Şen
AU  - Hatice Özdamar
AU  - Derya Seyman
AU  - Ayşe Batırel
AU  - Utku Zeybey
AU  - Çisem Oktay
AU  - Pelin Geyik Pekin
AU  - Selin Özdemir
AU  - Adem Köse
AU  - Kemalettin Özden
AU  - Oğuz Karabay
AU  - Şafak Kaya Kavak
AU  - Ali Mert
AU  - Sena Kaçan
AU  - Tuncay Güzel
AU  - Selda Aydın
AU  - Uğur Kostakoğlu
AU  - Seyit Ali Büyüktuna
AU  - Mesut Gitmez
AU  - Esma Kepenek Kurt
AU  - Fatma Zühre Alparslan Tanyeri
AU  - Veysi Can
AU  - Lütfü Bekar
AU  - Mehmet Çelik
AU  - Nazan Tuna
AU  - Şükran Köse
AU  - Mehmet Birhan Yılmaz
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical medicine
DO  - 10.3390/jcm15197760
UR  - https://europepmc.org/article/PMC/PMC13666091
AB  - 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. Results: The mean age of the overall study population was 58.08 ± 16.81 years, with a male predominance (60.6%, n = 285). Staphylococcus aureus was the most frequently isolated pathogen (27.9%), with a high proportion of methicillin resistance (38.9%). Hospital-acquired IE was identified in 41.1% of cases. Surgical treatment was performed in 40.6% (n = 191) of the cohort. The 28-day mortality rate was 11.9%, and the overall mortality during follow-up reached 26.4%. Multivariable Cox regression analysis identified hospital-acquired IE (HR = 2.247; 95% CI: 1.216–4.167; p = 0.010) and the presence of major clinical complications (HR = 4.207; 95% CI: 1.556–11.378; p = 0.005) as the strongest independent predictors of mortality. Conclusions: Contemporary infective endocarditis is a highly complex and fatal disease characterized by a prominent healthcare-associated burden and a predominant staphylococcal etiology. The occurrence of major clinical complications and hospital-acquired infections were the primary independent predictors of mortality.
SN  - 2077-0383
ER  -