What is the importance of non-nosocomial acquisition in Health care-associated native valve endocarditis? 
The importance of non-nosocomial acquisition of health care-associated native valve endocarditis is highlighted in a 2009 Annals of Internal Medicine article. The article states that non-nosocomial acquisition of native valve endocarditis is associated with higher mortality and morbidity compared to nosocomial acquisition. Furthermore, the article discusses the use of propensity score and instrumental variable methods to adjust for treatment-selection bias in order to assess the impact of early surgery on in-hospital mortality of native valve endocarditis. Additionally, a 2011 JAMA article discussed the association between valvular surgery and mortality among patients with infective endocarditis complicated by heart failure. Finally, a statement from the American Heart Association in 2007 outlines the diagnosis, antimicrobial therapy, and management of complications related to infective endocarditis.  