Description

Hasbun et al developed a prognostic score for adults with endocarditis involving a left-sided, native heart valve. This can help identify patients who require more aggressive therapy and closer monitoring. The authors are from Tulane and Yale Universities.


Parameters:

(1) mental status

(2) Charlson comorbidity scale

(3) congestive heart failure

(4) culture isolate

(5) therapy

 

Parameter

Finding

Points

mental status

alert

0

 

lethargic or disoriented

4

Charlson comorbidity

0 or 1

0

 

>= 2

3

congestive heart failure

none or mild

0

 

moderate to severe

3

culture isolate

viridans streptococci

0

 

Staphylococcus aureus

6

 

all other (Gram negative bacteria, fungi, culture negative, enterococcus, other streptococci, coagulase negative Staphylococcus, HACEK group)

8

therapy

surgical

0

 

medical only

5

from Table 4, page 1939

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 23

• The higher the score, the worse the prognosis.

 

Prognostic Group

6 month mortality (based on total cohort)

0 to 6

6%

7 to 11

17%

12 to 15

31%

16 to 23

63%

from Table 5, page 1939


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