Infective Endocarditis and Spondylodiscitis: Impact of Sequence of Surgical Therapy on Survival and Recurrence Rate

This retrospective multicentric study aimed to analyze the impact of the sequence of surgical treatment of concomitant infective endocarditis and spondylodiscitis on postoperative outcomes. Of a total of 3,991 patients with infective endocarditis, 150 patients (4.4 percent) had concomitant spondylodiscitis. Primary surgery for infective endocarditis was performed in 76.6 percent of patients, and primary surgery for spondylodiscitis in 23.3 percent of patients. The most common microorganisms detected were enterococci and staphylococcus aureus, followed by streptococci and coagulase-negative staphylococci. If spondylodiscitis was operated on first, 30-day mortality was significantly higher than if infective endocarditis was operated on first (25.7 percent versus 11.4 percent; p = 0.037). Primary surgery for spondylodiscitis was an independent predictor of 30-day mortality on multivariable regression analysis.