title: The need for a specific risk prediction system in native valve infective endocarditis surgery.
abstract: The need for a specific risk score system for infective endocarditis (IE) surgery has been previously claimed. In a single-center pilot study, preliminary to future multicentric development and validation, bivariate and multivariate (logistic regression) analysis of early postoperative mortality predictors in 440 native valve IE patients were performed. Mathematical procedures assigned scores to the independent predictors emerged (AUC of the ROC curve: 0.88). Overall mortality was 9.1%. Six predictors were identified and assigned scores, including age (5-13 points), renal failure (5), NYHA class IV (9), critical preoperative state (11), lack of preoperative attainment of blood culture negativity (5), perivalvular involvement (5). Four risk classes were drawn ranging from "very low risk" (≤5 points, mean predicted mortality 1%), and to "very high risk" (≥20 points, 43% mortality). IE-specific risk stratification models are both needed, as disease-specific factors (e.g., cultures, abscess), beside the generic ones (e.g., age, renal impairment) affect mortality, and feasible.
authors.affiliation: Department of Cardiothoracic Sciences, Second University of Naples, c/o V Monaldi Hospital, Via L. Bianchi, 80131 Naples, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cotrufo
authors.forename: Antonio
authors.initials: A
authors.lastname: Carozza
authors.forename: Luca S
authors.initials: LS
authors.lastname: De Santo
authors.forename: Francesco
authors.initials: F
authors.lastname: Amendolara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giordano
authors.forename: Ester E
authors.initials: EE
authors.lastname: Della Ratta
authors.forename: Gianantonio
authors.initials: G
authors.lastname: Nappi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Corte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D004696:Endocarditis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment