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

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:241

Article

Di Mauro, Michele¹  Dato, Guglielmo Mario Actis^4,6  Barili, Fabio⁵  Gelsomino, Sandro^1,2  Della Corte, Alessandro^4,5,6  Della Ratta, Ester^1,3,8  Cugola, Diego^4,6  Galletti, Lorenzo⁵  Devotini, Roger⁴  Casabona, Riccardo^1,3  Santini, Francesco⁵  Salsano, Antonio^1,3  Mancuso, Samuel⁸  Pozzoli, Alberto¹³  Benassi, Filippo¹¹  Rosato, Francesco^2,12  Grasso, Elena^7,10  Sandro, Sponga^12,15  Pacini, Davide^10,14  DeMartino, Andrea^12,15  Bortolotti, Uberto¹⁵  Onorati, Francesco^{8,10,11,14,15}  Faggian, Giuseppe⁷  Lorusso, Roberto^2,9  Vizzardi, Enrico¹³  Di Giammarco, Gabriele⁸  Serraino, Giuseppe²  Maselli, Daniele² 

[1] Univ G dAnnunzio, Cardiac Surg, Chieti, Italy

[2] Mauriziano Hosp, Cardiac Surg, Turin, Italy

[3] Maastricht Univ Med Ctr, Cardio Thorac Surg Dept, Heart Vasc Ctr, Maastricht, Netherlands

[4] Univ Naples 2, Cardiothorac Sci, Naples, Italy

[5] Cardiac Surg, AO, Papa Giovanni XXIII, Bergamo, Italy

[6] Univ Hosp, Cardiac Surg, IRCCS San Martino IST, Genoa, Italy

[7] Univ Milan, Sacco Hosp, Cardiac Surg, Milan, Italy

[8] Osped Niguarda Ca Granda, Cardiac Surg, Milan, Italy

[9] Univ Turin, Hosp, Cardiac Surg, Turin, Italy

[10] Univ Hosp, Cardiac Surg, Varese, Italy

[11] San Raffaele IRCCS Hosp, Cardiac Surg, Milan, Italy

[12] Maggiore Univ Hosp, Univ Parma, Cardiac Surg, Bologna, Italy

[13] AO Pisana Univ Hosp, Univ Pisa, Cardiac Surg, Pisa, Italy

[14] Univ Verona, Univ Hosp, Cardiac Surg, Verona, Italy

[15] Spedali Civili Hosp, T Cardiac Surg, Brescia, Italy

关键词: Infective endocarditis;    Risk score;    Valve surgery;   

DOI  :  10.1016/j.ijcard.2017.03.148

来源: Elsevier

【 摘 要 】

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 2 mg/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. (C) 2017 Published by Elsevier Ireland Ltd.

【 授权许可】

Free