2019 · SCANDINAVIAN CARDIOVASCULAR JOURNAL

Risk scores and surgery for infective endocarditis: in search of a good predictive score

Gatti, Giuseppe, Sponga, Sandro, Peghin, Maddalena, Givone, Filippo, Ferrara, Veronica, Benussi, Bernardo, Mazzaro, Enzo, Perrotti, Andrea, Bassetti, Matteo, Luzzati, Roberto, Chocron, Sidney, Pappalardo, Aniello, Livi, Ugolino

Journal
SCANDINAVIAN CARDIOVASCULAR JOURNAL
Année
2019
Volume
53
Numéro
3
Pages
117-124
Mois
MAY 4
DOI
10.1080/14017431.2019.1610188

Abstract

Objectives: To evaluate scoring systems that have been created to predict the risk of death post-surgery in infective endocarditis (IE).Design: Eight scores - (1) The Society of Thoracic Surgery (STS) risk score for IE, (2) De Feo score, (3) PALSUSE score (prosthetic valve, age >= 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE >= 10), (4) ANCLA score (anemia, New York Heart Association class IV, critical state, large intracardiac destruction, surgery of thoracic aorta), (5) Risk-Endocarditis Score (RISK-E), (6) score for heart valve or prosthesis IE (EndoSCORE), and (7,8) Association pour l'Etude et la Prevention de l'Endocadite Infectieuse (AEPEI) score I and II - were evaluated in 324 (mean age, 61.814.6 years) consecutive patients having IE and undergoing cardiac operation (1999-2018, Regione Autonoma Friuli-Venezia Giulia, Italy).Results: There were 45 (13.9%) in-hospital deaths. Despite many differences on the number and the type of variables, all the investigated scores showed good goodness-of-fit (Hosmer-Lemeshow test, p >=.28). For five scores, accuracy of prediction (receiver-operating characteristic curve analysis) was good (ANCLA score) or fair (STS risk score for IE, PALSUSE score, AEPEI score I and II). When compared one-to-one (Hanley-McNeil method), accuracy of prediction of ANCLA score was higher than all of other risk scores except for AEPEI score I (p=.077).Conclusions: Five of eight scores that were evaluated in this study showed satisfactory performance in predicting in-hospital mortality following surgery for IE. The ANCLA score should be preferred.

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