Costa et al developed a score for predicting in-hospital mortality for a patient with infective endocarditis. This can help to identify a patient who may benefit from more aggressive management. The authors are from Federal University in Brazil.
Patient selection: infective endocarditis
Outcome: in-hospital mortality
Parameters:
(1) age in years
(2) heart failure and NYHA class
(3) sepsis not responsive to antibiotic therapy
(4) conduction disorder
(5) cardiac arrhythmia
(6) echocardiographic classification
(7) vegetation diameter in mm
Parameter
Finding
Points
age of the patient
< 40 years
0
>= 40 years
4
heart failure
NYHA I to III AND no shock
0
NYHA IV OR shock
5
sepsis unresponsive
no
0
yes
6
conduction defect
no
0
yes
5
cardiac arrhythmia
no
0
yes
8
echocardiography
uncomplicated
0
complicated
5
prosthesis
5
vegetation diameter
>= 10 mm
4
< 10 mm or none seen
0
risk undex =
= SUM(points for all 7 parameters)
Interpretation:
• minimum index: 0
• maximum index: 37
• The higher the score the greater the in-hospital mortality/
Index
Mortality Rate
0 to 10
5.3%
11 to 15
33%
16 to 20
57%
21 to 37
79%
Performance:
• The area under the ROC curve for the index was 0.84.
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