Simple Scoring System to Predict In‐Hospital Mortality After Surgery for Infective Endocarditis
Authors: Gatti Giuseppe , Perrotti Andrea , Obadia Jean‐François , Duval Xavier , Iung Bernard , Alla François , Chirouze Catherine , Selton‐Suty Christine , Hoen Bruno , Sinagra Gianfranco , Delahaye François , Tattevin Pierre , Le Moing Vincent , Pappalardo Aniello , Chocron Sidney , Duval X. , Alla F. , Bouvet A. , Briancon S. , Cambau E. , Celard M. , Chirouze C. , Danchin N. , Doco‐ Lecompte T. , Delahaye F. , Etienne J. , Iung B. , Le Moing V. , Obadia J. F. , Leport C. , Poyart C. , Revest M. , Selton‐Suty C. , Strady C. , Tattevin P. , Vandenesch F. , Bernard Y. , Chocron S. , Chirouze C. , Hoen B. , Plesiat P. , Abouliatim I. , De Place C. , Tattevin P. , Revest M. , Donnio P. Y. , Alla F. , Carteaux J. P. , Doco‐Lecompte T. , Lion C. , Aissa N. , Selton‐Suty C. , Baehrel B. , Jaussaud R. , Nazeyrollas P. , Strady C. , Vernet V. , Cambau E. , Duval X. , Iung B. , Nataf P. , Chidiac C. , Celard M. , Delahaye F. , Obadia J. F. , Vandenesch F. , Aumaître H. , Frappier J. M. , Le Moing V. , Oziol E. , Sotto A. , Sportouch C. , Poyart C. , Bouvet A. , Vandenesch F. , Celard M. , Bes M. , Abrial E. , Acar C. , Aissa N. , Alexandra J. F. , Amireche N. , Amrein D. , Andre P. , Appriou M. , Arnould M. A. , Assayag P. , Atoui A. , Aziza F. , Baille N. , Bajolle N. , Battistella P. , Baumard S. , Ben Ali A. , Bertrand J. , Bialek S. , Bois Grosse M. , Boixados M. , Borlot F. , Bouchachi A. , Bouche O. , Bouchemal S. , Bourdon J. L. , Bouvet A. , Brasme L. , Bricaire F. , Brochet E. , Bruntz J. F. , Cady A. , Cailhol J. , Caplan M. P. , Carette B. , Carteaux J. P. , Cartry O. , Cazorla C. , Celard M. , Chamagne H. , Champagne H. , Chanques G. , Chastre J. , Chevalier B. , Chirouze C. , Chocron S. , Chometon F. , Christophe C. , Cohen A. , Colin de Verdiere N. , Danchin N. , Daneluzzi V. , David L. , De Lentdecker P , Delahaye F. , Delcey V. , Deleuze P. , Donal E. , Duval X. , Deroure B. , Descotes‐Genon V. , Didier Petit K. , Dinh A. , Doat V. , Duchene F. , Duhoux F. , Dupont M. , Ederhy S. , Epaulard O. , Evest M. , Faucher J. F. , Fantin B. , Fauveau E. , Ferry T. , Fillod M. , Floch T. , Fraisse T. , Frapier J. M. , Freysz L. , Fumery B. , Gachot B. , Gallien S. , Gandjbach I. , Garcon P. , Gaubert A. , Genoud J. L. , Ghiglione S. , Godreuil C. , Grentzinger A. , Groben L. , Gherissi D. , Guéret P. , Hagege A. , Hammoudi N. , Heliot F. , Henry P. , Herson S. , Hoen B. , Houriez P. , Hustache‐Mathieu L. , Huttin O. , Imbert S. , Iung B. , Jaureguiberry S. , Kaaki M. , Konate A. , Kuhn J. M. , Kural Menasche S. , Lafitte A. , Lafon B. , Lanternier F. , Le Chenault V. , Le Moing V. , Lechiche C. , Lefèvre‐Thibaut S. , Lefort A. , Leguerrier A. , Lemoine J. , Lepage L. , Leport C. , Lepouse ́ C. , Leroy J. , Lesprit P. , Letranchant L. , Loisance D. , Loncar G. , Lorentz C. , Mabo P. , Magnin‐Poull I. , May T. , Makinson A. , Man H. , Mansouri M. , Marxcon O. , Maroni J. P. , Masse V. , Maurier F. , Meyohas M. C. , Michel P. L. , Michelet C. , Mechaï F. , Merceron O. , Messika‐Zeitoun D. , Metref Z. , Meyssonnier V. , Mezher C. , Micheli S. , Monsigny M. , Mouly S. , Mourvillier B. , Nallet O. , Nataf P. , Nazeyrollas P. , Noel V. , Obadia J. F. , Oziol E. , Papo T. , Payet B. , Pelletier A. , Perez P. , Petit J. S. , Philippart F. , Piet E. , Plainvert C. , Popovic B. , Porte J. M. , Pradier P. , Ramadan R. , Revest M. , Richemond J. , Rodermann M. , Roncato M. , Roigt I. , Ruyer O. , Saada M. , Schwartz J. , Selton‐Suty C. , Simon M. , Simorre B. , Skalli S. , Spatz F. , Strady C. , Sudrial J. , Tartiere L. , Terrier De La Chaise A. , Thiercelin M. C. , Thomas D. , Thomas M. , Toko L. , Tournoux F. , Tristan A. , Trouillet J. L. , Tual L. , Vahanian A. , Verdier F. , Vernet Garnier V. , Vidal V. , Weyne P. , Wolff M. , Wynckel A. , Zannad N. , Zinzius P. Y. 
Published: July 2017

Background

Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (
IE
). The purpose of the present study was both to analyze the risk factors for in‐hospital death, which complicates surgery for
IE
, and to create a mortality risk score based on the results of this analysis.

Methods and Results

Outcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for
IE
in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in‐hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty‐six (15.5%) patients died postsurgery. BMI >27 kg/m
2
(odds ratio [
OR
], 1.79;
P
=0.049), estimated glomerular filtration rate <50 mL/min (
OR
, 3.52;
P
<0.0001), New York Heart Association class
IV
(
OR
, 2.11;
P
=0.024), systolic pulmonary artery pressure >55 mm Hg (
OR
, 1.78;
P
=0.032), and critical state (
OR
, 2.37;
P
=0.017) were independent predictors of in‐hospital death. A scoring system was devised to predict in‐hospital death postsurgery for
IE
(area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734–0.822). The score performed better than 5 of 6 scoring systems for in‐hospital death after cardiac surgery that were considered.

Conclusions

A simple scoring system based on risk factors for in‐hospital death was specifically created to predict mortality risk postsurgery in patients with
IE
.