Gatti et al developed two scores for predicting the risk of in-hospital mortality following surgery for infective endocarditis. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in France and are members of the Association pour l'Etude et la Prevention de l'Endocadite Infectieuse (AEPEI).
Parameters:
(1) estimated GFR in mL per minute
(2) NYHA class
(3) critical state (from Euroscore II)
Critical preoperative states
(1) ventricular tachycardia or fibrillation
(2) need for cardiac massage
(3) ventilation before arrival to OR
(4) inotrope support
(5) intra-aortic balloon counterpulsation or ventricular-assist device before arrival to OR
(6) acute renal failure (anuria or oliguria at < 10 mL per hour)
|
Parameter
|
Finding
|
beta-coefficient
|
Points
|
|
eGFR
|
>= 50 mL/min
|
0
|
0
|
|
|
< 50 mL/min
|
1.32
|
1.8
|
|
NYHA class
|
I to III
|
0
|
0
|
|
|
IV
|
0.75
|
1
|
|
critical state
|
0
|
0
|
0
|
|
|
1 or more
|
0.85
|
1.1
|
X =
= SUM(beta-coefficients) - 1.411
probability of in-hospital death =
= 1 / (1+EXP((-1)*X)))
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3.9
• The higher the score the greater the risk of in-hospital mortality.
|
Total Score
|
Expected Mortality
|
|
0 or 1
|
20 to 34%
|
|
1.1 to 1.8
|
37 to 48%
|
|
2.1 to 2.9
|
55 to 68%
|
|
3.9
|
82%
|
Performance:
• The areas under the ROC curve are 0.69 (on external validation) and 0.77 (Table 7).
