Gaca et al reported two risk scores for patients undergoing endocarditis surgery. One predicts postoperative mortality. The authors are from Duke University, Vanderbilt University and the University of Maryland.
Patient selection: surgery for infective endocarditis
Outcome: postoperative mortality within 30 days
Parameters:
(1) prior of CABG
(2) operative status
(3) preoperative IABP (intra-aortic balloon pump) or inotropes
(4) multiple valve procedure
(5) prior valve surgery
(6) diabetes
(7) hypertension
(8) chronic lung disease
(9) active endocarditis
(10) renal failure or serum creatinine > 2.0 mg/dL
(11) arrhythmia
Parameter
Finding
Points
prior CABG
no
0
yes
7
operative status
cardiogenic shock or salvage
17
urgent or emergency without shock
6
other
0
preoperative IABP or inotropes
no
0
yes
10
multiple valve procedure
no
0
yes
9
prior valve surgery
no
0
yes
8
diabetes
no
0
non-insulin dependent
6
insulin dependent
8
hypertension
no
0
yes
5
chronic lung disease
no
0
yes
5
active endocarditis
no
0
yes
10
renal failure
no
0
yes
12
arrhythmia
no
0
yes
8
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 99
• The higher the score the greater the mortality.
Total Score
Percent Mortality
0 to 6
< 2%
7 to 18
2 to 4%
19 to 27
5 to 7%
27 to 29
8%
30 to 33
10%
34 to 37
12%
38 to 43
15%
44 to 51
20%
>= 52
33%
from Figure 1A.
Performance:
• The area under the ROC curve was 0.76.
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