Background: Infective endocarditis has been associated with in-hospital mortality from 12.5% to 22.2%. Objective: To estimate the prognostic factors associated with in-hospital mortality in adult patients with a diagnosis of infectious endocarditis from 2007 to 2017. Methodology: Observational, analytical study, type cases and multicentric controls; considering patients with in-hospital mortality and controls patients with infective endocarditis who did not die during hospitalization. Results: 308 patients were included. In-hospital mortality was 32.7%. The main prognostic variables were: Complication with renal replacement therapy (OR 6,669 CI 3.77-12.17, p <0.001), moderate mitral compromise (OR 3.9 CI 1.02 -17.5 p = 0.057), Renal replacement therapy (RRT) prior to hospitalization (OR 3.72 CI 1.89 - 7.51, p <0.001) and central nervous system embolism (OR 2.6 CI 1.53 - 4.44, p < 0.001); as protective factors: surgery during hospitalization (OR 0.39 CI 0.24 - 0.64, p <0.001) and tricuspid involvement (OR 0.39 IC 0.15 - 0.87, p = 0.032). Conclusion: The development of acute renal injury with indication of RRT is the main risk factor for in-hospital mortality. The identification of acute renal injury as well as the limitation of the risk factors of the same can reduce the mortality conditioned by this factor. The performance of surgery during hospitalization is the factor of good prognosis with the greatest impact on mortality; The detection of criteria for surgical intervention should be emphasized during the management of this population.
