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Int J Cardiol. 2017 Aug 15;241:97-102. doi: 10.1016/j.ijcard.2017.03.148. Epub 2017 Apr 4.

A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE.

Author information

1
Cardiac Surgery, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy. Electronic address: mdimauro1973@gmail.com.
2
Cardiac Surgery, Mauriziano Hospital, Turin, Italy.
3
Cardiac Surgery, S. Croce Hospital, Cuneo, Italy.
4
Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.
5
Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
6
Cardiac Surgery, AO, Papa Giovanni XXIII, Bergamo, Italy.
7
Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy.
8
Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy.
9
Cardiac Surgery, Niguarda Hospital, Milan, Italy.
10
Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy.
11
Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy.
12
Cardiac Surgery, University Hospital, Varese, Italy.
13
Cardiac Surgery, University Hospital, Padua, Italy.
14
Cardiac Surgery, San Raffaele IRCCS Hospital, Milan, Italy.
15
Cardiac Surgery, Maggiore University Hospital, University of Parma, Italy.
16
Cardiac Surgery, S. Maria Misericordia Hospital, University of Udine, Udine, Italy.
17
Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
18
Cardiac Surgery, AO Pisana University Hospital, University of Pisa, Pisa, Italy.
19
Cardiac Surgery, University Hospital, University of Verona, Verona, Italy.
20
Cardiac Surgery, Spedali Civili Hospital, Brescia, Italy.
21
Cardiac Surgery, University "G. D'Annunzio" Chieti-Pescara, Chieti, Italy.
22
Cardiac Surgery, Poliambulanza Hospital, Brescia, Italy.
23
Cardiac Surgery, San Camillo-Forlanini Hospital, Rome, Italy.
24
Cardiac Surgery, University Hospital, University "Aldo Moro", Bari, Italy.
25
Cardiac Surgery, S. Anna e S. Sebastiano Hospital, Caserta, Italy.
26
Cardiac Surgery, Vito Fazi Hospital, Lecce, Italy.
27
Cardiac Surgery, University Hospital, University "Magna Grecia", Catanzaro, Italy.
28
Cardiac Surgery, University of Leicester, Leicester, United Kingdom.
29
Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy.

Abstract

BACKGROUND:

The aim of this large retrospective study was to provide a logistic risk model along an additive score to predict early mortality after surgical treatment of patients with heart valve or prosthesis infective endocarditis (IE).

METHODS:

From 2000 to 2015, 2715 patients with native valve endocarditis (NVE) or prosthesis valve endocarditis (PVE) were operated on in 26 Italian Cardiac Surgery Centers. The relationship between early mortality and covariates was evaluated with logistic mixed effect models. Fixed effects are parameters associated with the entire population or with certain repeatable levels of experimental factors, while random effects are associated with individual experimental units (centers).

RESULTS:

Early mortality was 11.0% (298/2715); At mixed effect logistic regression the following variables were found associated with early mortality: age class, female gender, LVEF, preoperative shock, COPD, creatinine value above 2mg/dl, presence of abscess, number of treated valve/prosthesis (with respect to one treated valve/prosthesis) and the isolation of Staphylococcus aureus, Fungus spp., Pseudomonas Aeruginosa and other micro-organisms, while Streptococcus spp., Enterococcus spp. and other Staphylococci did not affect early mortality, as well as no micro-organisms isolation. LVEF was found linearly associated with outcomes while non-linear association between mortality and age was tested and the best model was found with a categorization into four classes (AUC=0.851).

CONCLUSIONS:

The following study provides a logistic risk model to predict early mortality in patients with heart valve or prosthesis infective endocarditis undergoing surgical treatment, called "The EndoSCORE".

KEYWORDS:

Infective endocarditis; Risk score; Valve surgery

PMID:
28390740
DOI:
10.1016/j.ijcard.2017.03.148
[Indexed for MEDLINE]

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