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Description

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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