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Indian Journal of Thoracic and Cardiovascular Surgery
Published in:

18-12-2023 | Endocarditis | Review Article

Perioperative risk stratification scores in infective endocarditis and its usefulness

Authors: Laura Varela-Barca, Jose López-Menéndez

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Special Issue 1/2024

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Abstract

Infective endocarditis continues to represent a serious disease worldwide with high morbidity and mortality rates despite advances in diagnosis and treatment. Risk assessment plays a pivotal role in determining the appropriate course of treatment for patients diagnosed with infective endocarditis. In this context, specific endocarditis risk scores have been developed trying to help in the risk assessment process. During the last 15 years, 19 specific endocarditis scores have been published. These newly created scores are very heterogenous in their characteristics, factors included, and validation strategies. The purpose of this review is to analyze the published specific infective endocarditis risk scores and discuss their advantages, limitations, and usefulness.
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Literature
1.
Yang X, Chen H, Zhang D, Shen L, An G, Zhao S. Global magnitude and temporal trend of infective endocarditis, 1990–2019: results from the Global Burden of Disease Study. Eur J Prev Cardiol. 2022;29:1277–86.PubMedCrossRef
2.
Ambrosioni J, Hernández-Meneses M, Durante-Mangoni E, Tattevin P, Olaison L, Freiberger T, et al. Epidemiological changes and improvement in outcomes of infective endocarditis in Europe in the twenty-first century: an international collaboration on endocarditis (ICE) prospective cohort study (2000–2012). Infect Dis Ther. 2023;12:1083–101.PubMedPubMedCentralCrossRef
3.
Benito N, Miró JM, de Lazzari E, Cabell CH, del Río A, Altclas J, et al. Health care-associated native valve endocarditis: importance of non-nosocomial acquisition. Ann Intern Med. 2009;150:586–94.PubMedPubMedCentralCrossRef
4.
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36:3075–128.PubMedCrossRef
5.
Sy RW, Kritharides L. Health care exposure and age in infective endocarditis: results of a contemporary population-based profile of 1536 patients in Australia. Eur Heart J. 2010;31:1890–7.PubMedCrossRef
6.
Thornhill MH, Dayer MJ, Nicholl J, Prendergast BD, Lockhart PB, Baddour LM. An alarming rise in incidence of infective endocarditis in England since 2009: why? Lancet Lond Engl. 2020;395:1325–7.CrossRef
7.
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169:463–73.PubMedPubMedCentralCrossRef
8.
9.
Habib G, Erba PA, Iung B, Donal E, Cosyns B, Laroche C, et al. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J. 2019;40:3222–32.PubMedCrossRef
10.
Pazdernik M, Iung B, Mutlu B, Alla F, Riezebos R, Kong W, et al. Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry. Infection. 2022;50:1191–202.PubMedCrossRef
11.
Ambrosioni J, Hernandez-Meneses M, Téllez A, Pericàs J, Falces C, Tolosana JM, et al. The changing epidemiology of infective endocarditis in the twenty-first century. Curr Infect Dis Rep. 2017;19:21.PubMedCrossRef
12.
Prendergast BD, Tornos P. Surgery for infective endocarditis: who and when? Circulation. 2010;121:1141–52.PubMedCrossRef
13.
14.
Shahian DM, Jacobs JP, Badhwar V, Kurlansky PA, Furnary AP, Cleveland JC, et al. The society of thoracic surgeons 2018 adult cardiac surgery risk models: part 1—background, design considerations, and model development. Ann Thorac Surg. 2018;105:1411–8.PubMedCrossRef
15.
O’Brien SM, Feng L, He X, Xian Y, Jacobs JP, Badhwar V, et al. The society of thoracic surgeons 2018 adult cardiac surgery risk models: part 2—statistical methods and results. Ann Thorac Surg. 2018;105:1419–28.PubMedCrossRef
16.
Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 1999;16:9–13.CrossRef
17.
Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, Lockowandt U. EuroSCORE II. Eur J Cardiothorac Surg. 2012;41:734–44.PubMedCrossRef
18.
Rasmussen RV, Bruun LE, Lund J, Larsen CT, Hassager C, Bruun NE. The impact of cardiac surgery in native valve infective endocarditis: can euroSCORE guide patient selection? Int J Cardiol. 2011;149:304–9.PubMedCrossRef
19.
Lalani T, Cabell CH, Benjamin DK, Lasca O, Naber C, Fowler VG, et al. Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis: use of propensity score and instrumental variable methods to adjust for treatment-selection bias. Circulation. 2010;121:1005–13.PubMedPubMedCentralCrossRef
20.
Martínez-Sellés M, Muñoz P, Arnáiz A, Moreno M, Gálvez J, Rodríguez-Roda J, et al. Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis. Int J Cardiol. 2014;175:133–7.PubMedCrossRef
21.
Chu VH, Park LP, Athan E, Delahaye F, Freiberger T, Lamas C, et al. Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the international collaboration on endocarditis. Circulation. 2015;131:131–40.PubMedCrossRef
22.
Varela Barca L, López-Menéndez J, Redondo Palacios A, Rodríguez-Roda J. External validation of the new predictive model for early mortality after surgical treatment of infective endocarditis: analysis of the reliability of EndoSCORE. Int J Cardiol. 2018;268:99.PubMedCrossRef
23.
Wang T, Pemberton J. Performance of Endocarditis-Specific Risk Scores in Surgery for Infective Endocarditis. Thorac Cardiovasc Surg. 2018;66:333–5.PubMedCrossRef
24.
Rizzo V, Salmasi MY, Sabetai M, Primus C, Sandoe J, Lewis M, et al. Infective endocarditis: do we have an effective risk score model? A systematic review. Front Cardiovasc Med. 2023;10:1093363.PubMedCrossRef
25.
Fernández-Cisneros A, Hernández-Meneses M, Llopis J, Sandoval E, Pereda D, Alcocer J, et al. Risk scores’ performance and their impact on operative decision-making in left-sided endocarditis: a cohort study. Eur J Clin Microbiol Infect Dis. 2023;42:33–42.PubMedCrossRef
26.
Varela Barca L, Navas Elorza E, Fernández-Hidalgo N, Moya Mur JL, Muriel García A, Fernández-Felix BM, et al. Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis. Infection. 2019;47:879–95.PubMedCrossRef
27.
Costa MACD, Wollmann DR Jr, Campos ACL, Cunha CLPD, Carvalho RGD, Andrade DFD, et al. Índice de risco de mortalidade por endocardite infecciosa: um modelo logístico multivariado. Rev Bras Cir Cardiovasc. 2007;22.
28.
Gaca JG, Sheng S, Daneshmand MA, O’Brien S, Rankin JS, Brennan JM, et al. Outcomes for endocarditis surgery in North America: a simplified risk scoring system. J Thorac Cardiovasc Surg. 2011;141:98–106.e1-2.PubMedCrossRef
29.
López J, Fernández-Hidalgo N, Revilla A, Vilacosta I, Tornos P, Almirante B, et al. Internal and external validation of a model to predict adverse outcomes in patients with left-sided infective endocarditis. Heart Br Card Soc. 2011;97:1138–42.CrossRef
30.
De Feo M, Cotrufo M, Carozza A, De Santo LS, Amendolara F, Giordano S, et al. The need for a specific risk prediction system in native valve infective endocarditis surgery. Sci World J. 2012;2012:1–8.CrossRef
31.
Bjurman C, Snygg-Martin U, Olaison L, Fu MLX, Hammarsten O. Cystatin C in a composite risk score for mortality in patients with infective endocarditis: a cohort study. BMJ Open. 2012;2:e000856.PubMedPubMedCentralCrossRef
32.
Grubb A, Björk J, Nyman U, Pollak J, Bengzon J, Östner G, et al. Cystatin C, a marker for successful aging and glomerular filtration rate, is not influenced by inflammation. Scand J Clin Lab Invest. 2011;71:145–9.PubMedPubMedCentralCrossRef
33.
Chee QZ, Tan YQB, Ngiam JN, Win MTM, Shen X, Choo JNJ, et al. The SHARPEN clinical risk score predicts mortality in patients with infective endocarditis: an 11-year study. Int J Cardiol. 2015;191:273–6.PubMedCrossRef
34.
Alves SG, Pivatto Júnior F, Filippini FB, Dannenhauer GP, Miglioranza MH. SHARPEN score accurately predicts in-hospital mortality in infective endocarditis. Eur J Intern Med. 2021;92:124–7.PubMedCrossRef
35.
Park LP, Chu VH, Peterson G, Skoutelis A, Lejko-Zupa T, Bouza E, et al. Validated risk score for predicting 6-month mortality in infective endocarditis. J Am Heart Assoc. 2016;5:e003016.PubMedPubMedCentralCrossRef
36.
Di Mauro M, Dato GMA, Barili F, Gelsomino S, Santè P, Corte AD, et al. A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE. Int J Cardiol. 2017;241:97–102.PubMedCrossRef
37.
Gatti G, Perrotti A, Obadia J, Duval X, Iung B, Alla F, et al. Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis. J Am Heart Assoc. 2017;6:e004806.PubMedPubMedCentralCrossRef
38.
Olmos C, Vilacosta I, Habib G, Maroto L, Fernández C, López J, et al. Risk score for cardiac surgery in active left-sided infective endocarditis. Heart. 2017;103:1435–42.PubMedCrossRef
39.
Gelsomino S, Maessen JG, van der Veen F, Livi U, Renzulli A, Lucà F, et al. Emergency surgery for native mitral valve endocarditis: the impact of septic and cardiogenic shock. Ann Thorac Surg. 2012;93:1469–76.PubMedCrossRef
40.
Varela Barca L, López-Menéndez J, Miguelena Hycka J, Redondo Palacios A, Fajardo Rodríguez ER, Martín García M, et al. Valor pronóstico de la trombocitopenia preoperatoria en la cirugía de la endocarditis infecciosa: experiencia de un centro. Cir Cardiovasc. 2018;25:268–73.
41.
Gatti G, Benussi B, Gripshi F, Della Mattia A, Proclemer A, Cannatà A, et al. A risk factor analysis for in-hospital mortality after surgery for infective endocarditis and a proposal of a new predictive scoring system. Infection. 2017;45:413–23.PubMedCrossRef
42.
Fernández-Hidalgo N, Ferreria-González I, Marsal JR, Ribera A, Aznar ML, de Alarcón A, et al. A pragmatic approach for mortality prediction after surgery in infective endocarditis: optimizing and refining EuroSCORE. Clin Microbiol Infect. 2018;24:1102.e7–1102.e15.PubMedCrossRef
43.
Cheng HP, Biao WX, Ni LS, Lan CX, Hui KZ, Qing YD, et al. Risk prediction in infective endocarditis by modified MELD-XI score. Eur J Clin Microbiol Infect Dis. 2018;37:1243–50.CrossRef
44.
Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, et al. A model to predict survival in patients with end-stage liver disease. Hepatol Baltim Md. 2001;33:464–70.CrossRef
45.
Inohara T, Kohsaka S, Shiraishi Y, Goda A, Sawano M, Yagawa M, et al. Prognostic impact of renal and hepatic dysfunction based on the MELD-XI score in patients with acute heart failure. Int J Cardiol. 2014;176:571–3.PubMedCrossRef
46.
Kim MS, Kato TS, Farr M, Wu C, Givens RC, Collado E, et al. Hepatic dysfunction in ambulatory patients with heart failure: application of the MELD scoring system for outcome prediction. J Am Coll Cardiol. 2013;61:2253–61.PubMedPubMedCentralCrossRef
47.
Wei XB, Su ZD, Liu YH, Wang Y, Huang JL, Yu DQ, et al. Age, creatinine and ejection fraction (ACEF) score: a simple risk-stratified method for infective endocarditis. QJM Mon J Assoc Physicians. 2019;112:900–6.CrossRef
48.
Ranucci M, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G. Risk of assessing mortality risk in elective cardiac operations: age, creatinine, ejection fraction, and the law of parsimony. Circulation. 2009;119:3053–61.PubMedCrossRef
49.
Varela Barca L, Fernández-Felix BM, Navas Elorza E, Mestres CA, Muñoz P, Cuerpo-Caballero G, et al. Prognostic assessment of valvular surgery in active infective endocarditis: multicentric nationwide validation of a new score developed from a meta-analysis. Eur J Cardiothorac Surg. 2020;57:724–31.PubMedCrossRef
50.
García-Granja PE, López J, Vilacosta I, Sarriá C, Domínguez F, Ladrón R, et al. Predictive model of in-hospital mortality in left-sided infective endocarditis. Rev Esp Cardiol Engl Ed. 2020;73:902–9.PubMedCrossRef
51.
Garcia Granja PE, Lopez J, Vilacosta I, Saéz C, Cabezón G, Olmos C, et al. Prognostic impact of cardiac surgery in left-sided infective endocarditis according to risk profile. Heart. 2021;107:1987–94.PubMedCrossRef
52.
Fernandez-Felix BM, Barca LV, Garcia-Esquinas E, Correa-Pérez A, Fernández-Hidalgo N, Muriel A, et al. Prognostic models for mortality after cardiac surgery in patients with infective endocarditis: a systematic review and aggregation of prediction models. Clin Microbiol Infect. 2021;27:1422–30.PubMedCrossRef
53.
Luo L, Huang S, Liu C, Liu Q, Dong S, Yue Y, et al. Machine learning–based risk model for predicting early mortality after surgery for infective endocarditis. J Am Heart Assoc. 2022;11:e025433.PubMedPubMedCentralCrossRef
54.
Kumar A, Anstey C, Tesar P, Shekar K. Risk factors for mortality in patients undergoing cardiothoracic surgery for infective endocarditis. Ann Thorac Surg. 2019;108:1101–6.PubMedCrossRef
55.
Jakuska P, Ereminiene E, Muliuolyte E, Kosys V, Pavlavičius L, Zukovas G, et al. Predictors of early mortality after surgical treatment of infective endocarditis: a single-center experience. Perfusion. 2020;35:290–6.PubMedCrossRef
56.
Ramspek CL, Jager KJ, Dekker FW, Zoccali C, van Diepen M. External validation of prognostic models: what, why, how, when and where? Clin Kidney J. 2021;14:49–58.PubMedCrossRef
57.
Altman DG, Vergouwe Y, Royston P, Moons KGM. Prognosis and prognostic research: validating a prognostic model. BMJ. 2009;338:b605.PubMedCrossRef
58.
Gatti G, Sponga S, Peghin M, Givone F, Ferrara V, Benussi B, et al. Risk scores and surgery for infective endocarditis: in search of a good predictive score. Scand Cardiovasc J. 2019;53:117–24.PubMedCrossRef
59.
Urso S, Tena MÁ, Horcajada I, Paredes F, González-Barbeito M, Portela F. Prediction of surgical risk in patients with endocarditis: Comparison of logistic EuroSCORE, EuroSCORE II and APORTEI score. Enfermedades Infecc Microbiol Clínica. 2021;39:244–7.CrossRef
60.
Varela L, López-Menéndez J, Redondo A, Fajardo ER, Miguelena J, Centella T, et al. Mortality risk prediction in infective endocarditis surgery: reliability analysis of specific scores†. Eur J Cardiothorac Surg. 2018;53:1049–54.PubMedCrossRef
61.
Varela L, Vidal L, Fernández-Felix BM, Ventosa G, Navas E, Hidalgo I, et al. Estimación de la mortalidad quirúrgica de la endocarditis infecciosa: comparación de las diferentes escalas específicas de cálculo de riesgo. Cir Cardiovasc. 2020;27:93–9.
62.
Wang TKM, Wang MTM, Pemberton J. Risk scores and surgery for infective endocarditis: A meta-analysis. Int J Cardiol. 2016;222:1001–2.PubMedCrossRef
63.
Moons KGM, Wolff RF, Riley RD, Whiting PF, Westwood M, Collins GS, et al. PROBAST: a tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration. Ann Intern Med. 2019;170:W1–33.PubMedCrossRef
64.
Iung B, Doco-Lecompte T, Chocron S, Strady C, Delahaye F, Le Moing V, et al. Cardiac surgery during the acute phase of infective endocarditis: discrepancies between European Society of Cardiology guidelines and practices. Eur Heart J. 2016;37:840–8.PubMedCrossRef
65.
Gatti G, Chocron S, Obadia JF, Duval X, Iung B, Alla F, et al. Using surgical risk scores in nonsurgically treated infective endocarditis patients. Hellenic J Cardiol. 2020;61:246–52.PubMedCrossRef
66.
Varela Barca L, López-Menéndez J, Navas Elorza E, Moya Mur JL, Centella Hernéndez T, Redondo Palacios A, et al. Long-term prognosis after surgery for infective endocarditis: distinction between predictors of early and late survival. Enfermedades Infecc Microbiol Clínica. 2019;37:435–40.CrossRef
67.
Ramos-Martínez A, Calderón-Parra J, Miró JM, Muñoz P, Rodríguez-Abella H, Valerio M, et al. Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention. Int J Cardiol. 2019;282:24–30.PubMedCrossRef
Metadata
Title
Perioperative risk stratification scores in infective endocarditis and its usefulness
Authors
Laura Varela-Barca
Jose López-Menéndez
Publication date
18-12-2023
Publisher
Springer Nature Singapore
Keyword
Endocarditis
Published in
Indian Journal of Thoracic and Cardiovascular Surgery / Issue Special Issue 1/2024
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-023-01644-y

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