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
Purpose: To evaluate the prognosis for an adult with endocarditis involving a left-sided native heart valve using the score of Hasbun et al.
Specialty: Infectious Diseases, Cardiology
Objective: severity, prognosis, stage
ICD-10: I33,