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Multicenter Study
. 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

Michele Di Mauro  1 , Guglielmo Mario Actis Dato  2 , Fabio Barili  3 , Sandro Gelsomino  4 , Pasquale Santè  5 , Alessandro Della Corte  5 , Antonio Carrozza  5 , Ester Della Ratta  5 , Diego Cugola  6 , Lorenzo Galletti  6 , Roger Devotini  2 , Riccardo Casabona  2 , Francesco Santini  7 , Antonio Salsano  7 , Roberto Scrofani  8 , Carlo Antona  8 , Luca Botta  9 , Claudio Russo  9 , Samuel Mancuso  10 , Mauro Rinaldi  10 , Carlo De Vincentiis  11 , Andrea Biondi  11 , Cesare Beghi  12 , Giangiuseppe Cappabianca  12 , Vincenzo Tarzia  13 , Gino Gerosa  13 , Michele De Bonis  14 , Alberto Pozzoli  14 , Francesco Nicolini  15 , Filippo Benassi  15 , Francesco Rosato  3 , Elena Grasso  3 , Ugolino Livi  16 , Sandro Sponga  16 , Davide Pacini  17 , Roberto Di Bartolomeo  17 , Andrea De Martino  18 , Uberto Bortolotti  18 , Francesco Onorati  19 , Giuseppe Faggian  19 , Roberto Lorusso  4 , Enrico Vizzardi  20 , Gabriele Di Giammarco  21 , Daniele Marinelli  21 , Emmanuel Villa  22 , Giovanni Troise  22 , Marco Picichè  23 , Francesco Musumeci  23 , Domenico Paparella  24 , Vito Margari  24 , Francesco Tritto  25 , Girolamo Damiani  25 , Giuseppe Scrascia  26 , Salvatore Zaccaria  26 , Attilio Renzulli  27 , Giuseppe Serraino  27 , Giovanni Mariscalco  28 , Daniele Maselli  29 , Massimiliano Foschi  21 , Alessandro Parolari  11 , Giannantonio Nappi  5 ; Italian Group of Research for Outcome in Cardiac Surgery (GIROC)
Affiliations
Multicenter Study

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

Michele Di Mauro et al. Int J Cardiol. .

Erratum in

  • Corrigendum to "A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE". [Int. J. Cardiol. 241 (Aug 15 2017) 97-102].
    Di Mauro M, Dato GMA, Barili F, Gelsomino S, Santè P, Corte AD, Carrozza A, Ratta ED, Cugola D, Galletti L, Devotini R, Casabona R, Santini F, Salsano A, Scrofani R, Antona C, Botta L, Russo C, Mancuso S, Rinaldi M, De Vincentiis C, Biondi A, Beghi C, Cappabianca G, Tarzia V, Gerosa G, De Bonis M, Pozzoli A, Nicolini F, Benassi F, Rosato F, Grasso E, Livi U, Sponga S, Pacini D, Di Bartolomeo R, DeMartino A, Bortolotti U, Onorati F, Faggian G, Lorusso R, Vizzardi E, Di Giammarco G, Marinelli D, Villa E, Troise G, Picichè M, Musumeci F, Paparella D, Margari V, Tritto F, Damiani G, Scrascia G, Zaccaria S, Renzulli A, Serraino G, Mariscalco G, Maselli D, Foschi M, Parolari A, Nappi G; Italian Group of Research for Outcome in Cardiac Surgery (GIROC). Di Mauro M, et al. Int J Cardiol. 2018 May 1;258:337. doi: 10.1016/j.ijcard.2018.01.019. Epub 2018 Jan 12. Int J Cardiol. 2018. PMID: 29398138 No abstract available.

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.

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