Imperial College London
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Professor Thanos Athanasiou MD PhD MBA FECTS FRCS

Faculty of Medicine, Department of Surgery & Cancer

Professor of Cardiovascular Sciences
 
 
 
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Contact

 

t.athanasiou

 
 
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Location

 

1022Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rizzo:2023:10.3389/fcvm.2023.1093363,
author = {Rizzo, V and Salmasi, MY and Sabetai, M and Primus, C and Sandoe, J and Lewis, M and Woldman, S and Athanasiou, T},
doi = {10.3389/fcvm.2023.1093363},
journal = {Frontiers in Cardiovascular Medicine},
pages = {1--12},
title = {Infective endocarditis: do we have an effective risk score model? A systematic review},
url = {http://dx.doi.org/10.3389/fcvm.2023.1093363},
volume = {10},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundInfective endocarditis (IE) is a rare, highly morbid condition with 17% in-hospital mortality. 25-30% require surgery and there is ongoing debate with regard to markers predicting patient outcomes and guiding intervention. This systematic review aims to evaluate all IE risk scores currently available. Methods Standard methodology (PRISMA guideline) was used. Papers with risk score analysis for IE patients were included, with attention to studies reporting area under the receiver-operating characteristic curve(AUC/ROC). Qualitative analysis was carried out, including assessment of validation processes and comparison of these results to original derivation cohorts where available. Risk-of-bias analysis illustrated according to PROBAST guidelines. Results Of 75 articles initially identified, 32 papers were analysed for a total of 20 proposed scores, (range 66-13,000 patients), 14 of which were specific for IE. The number of variables per score ranged from 3 to 14 with only 50% including microbiological variables and 15% including biomarkers. The following scores had good performance (AUC>0.8) in studies proposing the score (often the derivation cohort); however fared poorly when applied to a new cohort: PALSUSE, DeFeo, ANCLA, RISK-E, EndoSCORE, MELD-XI, COSTA, SHARPEN.  DeFeo score demonstrated the largest discrepancy with initial AUC of 0.88, compared to 0.58 when applied to different cohorts.The inflammatory response in IE has been well documented and CRP has been found to be an independent predictor for worse outcomes. There is ongoing investigation on alternate inflammatory biomarkers which may assist in IE management. Of the scores identified in this review, only 3 have included a biomarker as a predictor.ConclusionDespite the variety of available scores, their development has been limited by small sample size, retrospective collection of data and short-term outcomes, with lack of external validation, limiting their transportability. Future population
AU  - Rizzo,V
AU  - Salmasi,MY
AU  - Sabetai,M
AU  - Primus,C
AU  - Sandoe,J
AU  - Lewis,M
AU  - Woldman,S
AU  - Athanasiou,T
DO  - 10.3389/fcvm.2023.1093363
EP  - 12
PY  - 2023///
SN  - 2297-055X
SP  - 1
TI  - Infective endocarditis: do we have an effective risk score model? A systematic review
T2  - Frontiers in Cardiovascular Medicine
UR  - http://dx.doi.org/10.3389/fcvm.2023.1093363
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2023.1093363/full
UR  - http://hdl.handle.net/10044/1/102899
VL  - 10
ER  -
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