Gaca et al reported two risk scores for patients undergoing endocarditis surgery. One predicts postoperative morbidity and mortality. The authors are from Duke University, Vanderbilt University and the University of Maryland.
Patient selection: surgery for infective endocarditis
Outcome: postoperative morbidity and mortality within 30 days
Parameters:
(1) gender
(2) body surface area > 1.9 square meters
(3) age in years
(4) prior of CABG
(5) operative status
(6) preoperative IABP (intra-aortic balloon pump) or inotropes
(7) multiple valve procedure
(8) prior valve surgery
(9) diabetes
(10) active endocarditis
(11) renal failure or serum creatinine > 2.0 mg/dL
(12) arrhythmia
Parameter
Finding
Points
gender
male
0
female
5
age in years
<= 60 years
0
> 60 years
4
body surface area
<= 1.9 square meters
0
> 1.9 square meters
1
prior CABG
no
0
yes
5
operative status
cardiogenic shock or salvage
17
urgent or emergency without shock
6
other
0
preoperative IABP or inotropes
no
0
yes
12
multiple valve procedure
no
0
yes
7
prior valve surgery
no
0
yes
5
diabetes
no
0
non-insulin dependent
0
insulin dependent
7
NYHA
NYHA I to III
0
NYHA IV
6
active endocarditis
no
0
yes
7
renal failure
no
0
yes
12
arrhythmia
no
0
yes
5
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 93
• The risk for morbidity or mortality increases with the score.
• The risk is 14% for a score from 0 to 3. A score >= 46 has a risk of 83%.
Performance:
• The area under the ROC curve was 0.73.
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