Revilla et al identified risk factors for mortality following urgent surgery for infective endocarditis. These can help to identify patients who may require more aggressive management. The authors are from Hospital Clinico Universitario in Valladolid, Hospital Clinico San Carlos in Madrid and Hospital Rio Hortega in Valladolid, Spain.
Patient selection: infectious endocarditis following urgent surgery
Outcome: in-hospital mortality
Risk factors identified on multivariate analysis:
(1) heart failure on admission
(2) renal failure
(3) persistent infection after surgery
X =
= (1.068 if renal failure present) + (1.254 if infection persistent) – (0.111 if heart failure present) – 1.399
probability of in-hospital mortality =
= 1 / (1 + EXP((-1) *X))
Additional factors from the univariate analysis:
(1) septic shock
(2) thrombocytopenia
(3) anemia
(4) hepatic dysfunction (elevated SGPT)
(5) marked leukocytosis
Some of the risk factors reflect onset of multi-organ failure.
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