Effects of Delay from Symptom Onset to Diagnosis in Infective Endocarditis: Findings from the National NIDUS Registry
By
Mads-Gustav Nebel Hvidt
Amna Alhakak
Peter Laursen Graversen
Katra Hadji-Turdeghal
Jacob Eifer Møller
Niels Eske Bruun
Kasper Karmark Iversen
Jonas Agerlund Povlsen
Claus Moser
Morten Holdgaard Smerup
Daniel Faurholt-Jepsen
Henning Bundgaard
Lauge Østergaard
Lars Køber
Emil Loldrup Fosbøl
August 31, 2026
Clinical Scorecard: Effects of Delay from Symptom Onset to Diagnosis in Infective Endocarditis: Findings from the National NIDUS Registry
At a Glance
Category Detail
Condition Infective Endocarditis Key Mechanisms Heterogeneous presentation with non-specific symptoms; diagnosis based on modified Duke criteria and ESC guidelines. Target Population Patients diagnosed with possible or definite infective endocarditis in Denmark from 2016 to 2021. Care Setting Observational cohort study using the National Danish Endocarditis Study (NIDUS) database.
Key Highlights
Symptom duration before diagnosis varies significantly among patients. Shorter prediagnostic symptom duration is linked to higher mortality. Microbial aetiology established through blood cultures. Surgical indications based on ESC guidelines include heart failure and persistent vegetations. All-cause mortality at 6 months is the primary outcome measure. Guideline-Based Recommendations
Diagnosis
Use modified Duke criteria and 2015 ESC diagnostic criteria for infective endocarditis. Management
Consider Class I surgical indications for patients with heart failure or persistent vegetations. Monitoring & Follow-up
Follow-up for all-cause mortality at 6 months post-diagnosis. Risks
Higher mortality associated with shorter symptom duration before diagnosis. Patient & Prescribing Data
Patients diagnosed with infective endocarditis in Denmark.
Treatment strategies include antibiotic therapy and surgical intervention based on clinical presentation.
Clinical Best Practices
Timely diagnosis and treatment initiation are crucial for improving outcomes. Regular monitoring of symptom duration and associated complications is recommended. Related Resources & Content
