Female sex is not associated with worse surgical outcomes in infective endocarditis: a prospective study disproving a common assumption

To evaluate the impact of sex on in-hospital mortality following surgery for infective endocarditis (IE) and assess mid-term outcomes.

Study Design: Single-center, observational, prospective cohort study including 264 patients diagnosed and treated for IE from January 2023 to December 2025.
Patient Selection: Included 117 surgically treated patients with a formal indication for cardiac surgery.
Data Collection: Data on baseline characteristics, comorbidities, and clinical presentation were collected using a secure web-based platform.
Analysis: Evaluated in-hospital mortality and mid-term outcomes, comparing results between sexes.

117 patients underwent cardiac surgery for IE, with 22 (18.8%) being female.
Overall in-hospital mortality was 12.8% with no significant sex-related differences (9.1% in males vs. 13.7% in females, p = 0.561).
The proportion of patients with a formal surgical indication was similar in women and men (67.2% vs. 75.6%, p = 0.175), but women tended to undergo cardiac surgery less frequently than men (48.9% vs. 63.8%).

The study indicates that female sex did not emerge as an independent predictor of in-hospital mortality or mid-term outcomes.

Findings indicate the need for individualized clinical judgment to prevent treatment disparities based on sex.