Patient selection: infective endocarditis
Outcome: 6-month mortality
Parameters for the risk model on day 8 of hospitalization (after 1 week):
(1) Charlson comorbidity index
(2) congestive heart failure
(3) platelet count in 10^9/L
(4) serum creatinine in µmol/L
(5) severe embolic event (with permanent disability, organ dysfunction and/or requiring emergency surgery)
|
Parameter
|
Finding
|
Points
|
|
Charlson comorbidity
|
< 3
|
0
|
|
|
>= 3
|
2
|
|
congestive heart failure
|
no
|
0
|
|
|
yes
|
3
|
|
platelet count
|
>= 150 * 10^9/L
|
0
|
|
|
< 150 * 10^9/L
|
2
|
|
serum creatinine
|
< 120 µmol/L
|
0
|
|
|
>= 120 µmol/L
|
2
|
|
severe embolic event
|
absent
|
0
|
|
|
present
|
2
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
|
Score
|
Risk Group
|
Mortality
|
|
0 to 3
|
low
|
9%
|
|
4 or 5
|
intermediate
|
32%
|
|
6 to 11
|
high
|
81%
|
from Figure 3
A patient judged to be at low-risk on days 1, 8 and 15 had a 6-month mortality of 2.4%.
A patient judged high risk on any of the days had a 6-month mortality of 78%.
Everyone else had a 6-month mortality of 20%.
Performance:
• The area under the ROC curve is 0.79.
