Observational Study

. 2017 Jul 20;6(7):e004806.

doi: 10.1161/JAHA.116.004806.

Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis

Giuseppe Gatti¹, Andrea Perrotti², Jean-François Obadia³, Xavier Duval^{4

5}, Bernard Iung^{6

7}, François Alla⁸, Catherine Chirouze⁹, Christine Selton-Suty¹⁰, Bruno Hoen¹¹, Gianfranco Sinagra¹², François Delahaye³, Pierre Tattevin¹³, Vincent Le Moing^{13

14}, Aniello Pappalardo¹², Sidney Chocron²; Association for the Study and Prevention of Infective Endocarditis Study Group–Association pour l'Étude et la Prévention de l'Endocadite Infectieuse (AEPEI)

Collaborators, Affiliations

Collaborators

Association for the Study and Prevention of Infective Endocarditis Study Group–Association pour l'Étude et la Prévention de l'Endocadite Infectieuse (AEPEI):
X Duval, F Alla, A Bouvet, S Briancon, E Cambau, M Celard, C Chirouze, N Danchin, T Doco-Lecompte, F Delahaye, J Etienne, B Iung, V Le Moing, J F Obadia, C Leport, C Poyart, M Revest, C Selton-Suty, C Strady, P Tattevin, F Vandenesch, Y Bernard, S Chocron, C Chirouze, B Hoen, P Plesiat, I Abouliatim, C De Place, P Tattevin, M Revest, P Y Donnio, F Alla, J P Carteaux, T Doco-Lecompte, C Lion, N Aissa, C Selton-Suty, B Baehrel, R Jaussaud, P Nazeyrollas, C Strady, V Vernet, E Cambau, X Duval, B Iung, P Nataf, C Chidiac, M Celard, F Delahaye, J F Obadia, F Vandenesch, H Aumaître, J M Frappier, V Le Moing, E Oziol, A Sotto, C Sportouch, C Poyart, A Bouvet, F Vandenesch, M Celard, M Bes, E Abrial, C Acar, N Aissa, J F Alexandra, N Amireche, D Amrein, P Andre, M Appriou, M A Arnould, P Assayag, A Atoui, F Aziza, N Baille, N Bajolle, P Battistella, S Baumard, A Ben Ali, J Bertrand, S Bialek, M Bois Grosse, M Boixados, F Borlot, A Bouchachi, O Bouche, S Bouchemal, J L Bourdon, A Bouvet, L Brasme, F Bricaire, E Brochet, J F Bruntz, A Cady, J Cailhol, M P Caplan, B Carette, J P Carteaux, O Cartry, C Cazorla, M Celard, H Chamagne, H Champagne, G Chanques, J Chastre, B Chevalier, C Chirouze, S Chocron, F Chometon, C Christophe, A Cohen, N Colin de Verdiere, N Danchin, V Daneluzzi, L David, P De Lentdecker, F Delahaye, V Delcey, P Deleuze, E Donal, X Duval, B Deroure, V Descotes-Genon, K Didier Petit, A Dinh, V Doat, F Duchene, F Duhoux, M Dupont, S Ederhy, O Epaulard, M Evest, J F Faucher, B Fantin, E Fauveau, T Ferry, M Fillod, T Floch, T Fraisse, J M Frapier, L Freysz, B Fumery, B Gachot, S Gallien, I Gandjbach, P Garcon, A Gaubert, J L Genoud, S Ghiglione, C Godreuil, A Grentzinger, L Groben, D Gherissi, P Guéret, A Hagege, N Hammoudi, F Heliot, P Henry, S Herson, B Hoen, P Houriez, L Hustache-Mathieu, O Huttin, S Imbert, B Iung, S Jaureguiberry, M Kaaki, A Konate, J M Kuhn, S Kural Menasche, A Lafitte, B Lafon, F Lanternier, V Le Chenault, V Le Moing, C Lechiche, S Lefèvre-Thibaut, A Lefort, A Leguerrier, J Lemoine, L Lepage, C Leport, C Lepouse, J Leroy, P Lesprit, L Letranchant, D Loisance, G Loncar, C Lorentz, P Mabo, I Magnin-Poull, T May, A Makinson, H Man, M Mansouri, O Marxcon, J P Maroni, V Masse, F Maurier, M C Meyohas, P L Michel, C Michelet, F Mechaï, O Merceron, D Messika-Zeitoun, Z Metref, V Meyssonnier, C Mezher, S Micheli, M Monsigny, S Mouly, B Mourvillier, O Nallet, P Nataf, P Nazeyrollas, V Noel, J F Obadia, E Oziol, T Papo, B Payet, A Pelletier, P Perez, J S Petit, F Philippart, E Piet, C Plainvert, B Popovic, J M Porte, P Pradier, R Ramadan, M Revest, J Richemond, M Rodermann, M Roncato, I Roigt, O Ruyer, M Saada, J Schwartz, C Selton-Suty, M Simon, B Simorre, S Skalli, F Spatz, C Strady, J Sudrial, L Tartiere, A Terrier De La Chaise, M C Thiercelin, D Thomas, M Thomas, L Toko, F Tournoux, A Tristan, J L Trouillet, L Tual, A Vahanian, F Verdier, V Vernet Garnier, V Vidal, P Weyne, M Wolff, A Wynckel, N Zannad, P Y Zinzius

Affiliations

¹ Cardiovascular Department, University Hospital of Trieste, Italy gius.gatti@gmail.com.
² Department of Thoracic and Cardiovascular Surgery, EA3920, University Hospital Jean Minjoz, Besançon, France.
³ Cardiology Hospital Louis Pradel, Hospices Civils, Lyon, France.
⁴ IAME, Inserm UMR 1137, University Paris Diderot Sorbonne Paris Cité, Paris, France.
⁵ Inserm Clinical Investigation Center 1425, Paris, France.
⁶ Department of Cardiology, AP-HP, Bichat Hospital, Paris, France.
⁷ DHU Fire, Paris, France.
⁸ EA 4003, University of Nancy, France.
⁹ Department of Infective and Tropical Diseases, University Hospital Jean Minjoz, Besançon, France.
¹⁰ Department of Cardiology, University Hospital of Nancy, France.
¹¹ Department of Infective and Tropical Diseases, University Hospital of Pointe à Pitre, France.
¹² Cardiovascular Department, University Hospital of Trieste, Italy.
¹³ Department of Infective and Tropical Diseases, University Regional Hospital, Rennes, France.
¹⁴ UMI 233, Institute of Development Research, University of Montpellier, France.

PMID: 28729412
PMCID: PMC5586260
DOI: 10.1161/JAHA.116.004806

Observational Study

Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis

Giuseppe Gatti et al. J Am Heart Assoc. 2017.

. 2017 Jul 20;6(7):e004806.

doi: 10.1161/JAHA.116.004806.

Authors

Collaborators

Association for the Study and Prevention of Infective Endocarditis Study Group–Association pour l'Étude et la Prévention de l'Endocadite Infectieuse (AEPEI):
X Duval, F Alla, A Bouvet, S Briancon, E Cambau, M Celard, C Chirouze, N Danchin, T Doco-Lecompte, F Delahaye, J Etienne, B Iung, V Le Moing, J F Obadia, C Leport, C Poyart, M Revest, C Selton-Suty, C Strady, P Tattevin, F Vandenesch, Y Bernard, S Chocron, C Chirouze, B Hoen, P Plesiat, I Abouliatim, C De Place, P Tattevin, M Revest, P Y Donnio, F Alla, J P Carteaux, T Doco-Lecompte, C Lion, N Aissa, C Selton-Suty, B Baehrel, R Jaussaud, P Nazeyrollas, C Strady, V Vernet, E Cambau, X Duval, B Iung, P Nataf, C Chidiac, M Celard, F Delahaye, J F Obadia, F Vandenesch, H Aumaître, J M Frappier, V Le Moing, E Oziol, A Sotto, C Sportouch, C Poyart, A Bouvet, F Vandenesch, M Celard, M Bes, E Abrial, C Acar, N Aissa, J F Alexandra, N Amireche, D Amrein, P Andre, M Appriou, M A Arnould, P Assayag, A Atoui, F Aziza, N Baille, N Bajolle, P Battistella, S Baumard, A Ben Ali, J Bertrand, S Bialek, M Bois Grosse, M Boixados, F Borlot, A Bouchachi, O Bouche, S Bouchemal, J L Bourdon, A Bouvet, L Brasme, F Bricaire, E Brochet, J F Bruntz, A Cady, J Cailhol, M P Caplan, B Carette, J P Carteaux, O Cartry, C Cazorla, M Celard, H Chamagne, H Champagne, G Chanques, J Chastre, B Chevalier, C Chirouze, S Chocron, F Chometon, C Christophe, A Cohen, N Colin de Verdiere, N Danchin, V Daneluzzi, L David, P De Lentdecker, F Delahaye, V Delcey, P Deleuze, E Donal, X Duval, B Deroure, V Descotes-Genon, K Didier Petit, A Dinh, V Doat, F Duchene, F Duhoux, M Dupont, S Ederhy, O Epaulard, M Evest, J F Faucher, B Fantin, E Fauveau, T Ferry, M Fillod, T Floch, T Fraisse, J M Frapier, L Freysz, B Fumery, B Gachot, S Gallien, I Gandjbach, P Garcon, A Gaubert, J L Genoud, S Ghiglione, C Godreuil, A Grentzinger, L Groben, D Gherissi, P Guéret, A Hagege, N Hammoudi, F Heliot, P Henry, S Herson, B Hoen, P Houriez, L Hustache-Mathieu, O Huttin, S Imbert, B Iung, S Jaureguiberry, M Kaaki, A Konate, J M Kuhn, S Kural Menasche, A Lafitte, B Lafon, F Lanternier, V Le Chenault, V Le Moing, C Lechiche, S Lefèvre-Thibaut, A Lefort, A Leguerrier, J Lemoine, L Lepage, C Leport, C Lepouse, J Leroy, P Lesprit, L Letranchant, D Loisance, G Loncar, C Lorentz, P Mabo, I Magnin-Poull, T May, A Makinson, H Man, M Mansouri, O Marxcon, J P Maroni, V Masse, F Maurier, M C Meyohas, P L Michel, C Michelet, F Mechaï, O Merceron, D Messika-Zeitoun, Z Metref, V Meyssonnier, C Mezher, S Micheli, M Monsigny, S Mouly, B Mourvillier, O Nallet, P Nataf, P Nazeyrollas, V Noel, J F Obadia, E Oziol, T Papo, B Payet, A Pelletier, P Perez, J S Petit, F Philippart, E Piet, C Plainvert, B Popovic, J M Porte, P Pradier, R Ramadan, M Revest, J Richemond, M Rodermann, M Roncato, I Roigt, O Ruyer, M Saada, J Schwartz, C Selton-Suty, M Simon, B Simorre, S Skalli, F Spatz, C Strady, J Sudrial, L Tartiere, A Terrier De La Chaise, M C Thiercelin, D Thomas, M Thomas, L Toko, F Tournoux, A Tristan, J L Trouillet, L Tual, A Vahanian, F Verdier, V Vernet Garnier, V Vidal, P Weyne, M Wolff, A Wynckel, N Zannad, P Y Zinzius

Affiliations

¹ Cardiovascular Department, University Hospital of Trieste, Italy gius.gatti@gmail.com.
² Department of Thoracic and Cardiovascular Surgery, EA3920, University Hospital Jean Minjoz, Besançon, France.
³ Cardiology Hospital Louis Pradel, Hospices Civils, Lyon, France.
⁴ IAME, Inserm UMR 1137, University Paris Diderot Sorbonne Paris Cité, Paris, France.
⁵ Inserm Clinical Investigation Center 1425, Paris, France.
⁶ Department of Cardiology, AP-HP, Bichat Hospital, Paris, France.
⁷ DHU Fire, Paris, France.
⁸ EA 4003, University of Nancy, France.
⁹ Department of Infective and Tropical Diseases, University Hospital Jean Minjoz, Besançon, France.
¹⁰ Department of Cardiology, University Hospital of Nancy, France.
¹¹ Department of Infective and Tropical Diseases, University Hospital of Pointe à Pitre, France.
¹² Cardiovascular Department, University Hospital of Trieste, Italy.
¹³ Department of Infective and Tropical Diseases, University Regional Hospital, Rennes, France.
¹⁴ UMI 233, Institute of Development Research, University of Montpellier, France.

PMID: 28729412
PMCID: PMC5586260
DOI: 10.1161/JAHA.116.004806

Abstract

Background: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis.

Methods and results: Outcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m² (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate <50 mL/min (OR, 3.52; P<0.0001), New York Heart Association class IV (OR, 2.11; P=0.024), systolic pulmonary artery pressure >55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered.

Conclusions: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE.

Keywords: cardiac valvular surgery; critical care; infective endocarditis; mortality; predictors; pulmonary hypertension; quality control; treatment outcome.

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Figures

**Figure 1**
The new predictive scoring system for in‐hospital death postsurgery for IE (the AEPEI score) vs (A) three scoring systems specifically created to predict in‐hospital (or 30‐day) mortality postsurgery for IE and (B) 3 predictive scoring systems for in‐hospital (or 30‐day) mortality after cardiac surgery. AEPEI indicates Association pour l'Etude et la Prévention de l'Endocadite Infectieuse; AUC, area under the receiver operating characteristic curve; EuroSCORE, European System for Cardiac Operative Risk Evaluation; IE, infective endocarditis; OPR, Ontario Province Risk; PALSUSE, Prosthetic valve, Age ≥70, Large intracardiac destruction, *Staphylococcus* spp, Urgent surgery, Sex [female], EuroSCORE ≥10; STS, the Society of Thoracic Surgeons.

**Figure 2**
External validation of the AEPEI score in a validation sample of 161 patients: discriminatory power. AEPEI indicates Association pour l'Etude et la Prévention de l'Endocadite Infectieuse; AUC, area under the receiver‐operating characteristic curve.

**Figure 3**
AEPEI score discriminatory power: the original 5‐variable model vs the alternate 3‐variable model. AEPEI indicates Association pour l'Etude et la Prévention de l'Endocadite Infectieuse; AUC, area under the receiver operating characteristic curve.

See this image and copyright information in PMC

References

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Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis

Collaborators

Affiliations

Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis

Authors

Collaborators

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

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Medical