Risk index for death by infective endocarditis: a multivariate logistic model.
OBJECTIVE
This study aimed at identifying predictive variables for in-hospital mortality, calculating the probability of death and creating a risk index for death by infective endocarditis by comparing two methods using a Receiver Operating Characteristic (ROC) curve.


METHODS
A retrospective study was conducted of 186 consecutive cases of confirmed infective endocarditis divided into two groups: discharged (137) and in-hospital death (49). Based on the odds ratios obtained by multivariate analysis, the probability of death was calculated and a mortality risk index created.


RESULTS
Factors predictive of higher mortality (multivariate analysis) and the risk index, with their respective weights were: age >or= 40 years (OR = 4.16; 95%CI [1.63-10.80] - 4 points), class IV heart failure or cardiovascular shock (OR = 4.93; 95%CI [1.86-13.05] - 5 points), uncontrolled sepsis (OR = 5.97; 95%CI [1.95-18.35] - 6 points), conduction disorder (OR = 5.07; 95%CI [1.67-15.35] - 5 points), arrhythmia (OR = 8.17; 95%CI [2.60-25.71] - 8 points), valve with extensive damage or abscess or prosthesis (OR = 4.77; 95%CI [1.44-15.76] - 5 points) and large and mobile vegetation (OR = 4.36; 95%CI [1.55-12.90] - 4 points). Patients with scores between 0 and 10 had a mortality of 5.26% and scores over 20 of 78.9%.


CONCLUSIONS
The higher the score, the higher the mortality rate. The mortality risk index may be used to estimate mortality in Infective Endocarditis.
Costa
Mário Augusto Cray da
MA
Hospital de Clínicas, Federal University in Paraná- Brazil Rua General Carneiro,181, Curitiba. drmarioaugusto@uol.com.br
Wollmann
Darley Rugery
DR
Campos
Antonio Carlos Ligoski
AC
Cunha
Cláudio Leinig Pereira da
CL
Carvalho
Roberto Gomes de
RG
Andrade
Dalton Francisco de
DF
Loures
Danton Richilin Rocha
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004697:Endocarditis, Bacterial / Q000150:complications / Q000401:mortality* / Q000628:therapy; D015340:Epidemiologic Research Design; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000150:complications / Q000401:mortality; D013223:Statistics as Topic