Value of euroscore ii to predict operative mortality in infectious endocarditis surgery.

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Published Mar 6, 2018
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Vol. 95 No. 7 (2017): Issue Jul 2017

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Karima Taamallah
Wafa Ibala
Walid Ghodhbane
Slim Chenik

Abstract

Background: Stratification of surgical risk is an important step in cardiac surgery, often based on the estimation of operative mortality. The EuroSCORE II (ES II) incorporates several factors in the calculation of mortality, but few are specific to Infectious endocarditis (IE).
Aim: Our study is aimed to evaluate the predictive power of the Es II in the surgery of IE and to test its discriminating power according to certain specific parameters of the IE.
Methods: 55 surgical procedures were carried out between January 2000 and June 2012 (37 EI on native valves and 18 on prosthesis). The mortality observed was compared with the mortality predicted by Es II. The discriminant capacity of the Es II model was tested using the receiver operating characteristic (ROC) curve model by comparing the areas under the curve (AsC).
Results: For our cohort The observed mortality was 30.9 % , the mortality predicted by Es II was 10.5%. in general, the EsII discriminatory capacity for mortality was satisfactory: the ROC AsC was 0,76. By analyzing the subgroups of the endocarditis, Es II lost its discriminating power: theROC AsC was: 0.64 for staphylococcal, 0.62 for the annular abscess and 0.56 for endocarditis on prosthesis.
Conclusion: The EuroSCORE II model has a satisfactory discriminating power in the IE. However, analysis of subgroups leads to decrease in
this discriminating power. Thus, some specific parameters of the IE, which do not appear in the EuroSCORE II model, should be taken into accountwhen analyzing mortality.

Keywords:

Infectious endocarditis, cardiac surgery, mortality, score.

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References

  1. Hammami A, Kammoun S, Ben Jemaa M. les endocardites infectieuses enquête nationale tunisienne. Revue tunisienne d'infectiologie 2007;1:32-4.
  2. Roques F, Michel P, Goldstone A-R et al. The logistic EuroSCORE. Eur Heart J 2003;24:1-2.
  3. Edwards FH, Peterson ED, Coombs LP, et al. Prediction of operative mortality after valve replacement surgery. J Am CollCardiol 2001; 37:885-92.
  4. Roques F, Nashef S-A-M, Michel P et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardio-thoracSurg 1999;15:816-23
  5. Jin R, Grunkemeier G L. Additive vs. logistic risk models for cardiac surgery mortality. Eur J CardiothoracSurg2005;28:240-3.
  6. Michel P, Roques F, Nashef SAM. Logistic or additive EuroSCORE for high-risk patients? . Eur J CardiothoracSurg 200323 (2003);23: 684-7.
  7. Zingone B, Pappalardo A, Dreas L. Logistic versus additive EuroSCORE. A comparative assessment of the two models in an independent population.Eur J CardiothoracSurg 2004;26:1134-40.
  8. Bhatti F, Grayson AD, Grotte G et al. The logistic EuroSCORE in cardiac surgery: how well does it predict operative risk? Heart 2006;92:1817-20.
  9. Iung B. Management of the elderly patient with aortic stenosis. Heart 2008;94:519-24.
  10. Brown ML, Schaff HV, et al. Is the European System for Cardiac Operative Risk Evaluation model valid for estimating the operative risk of patients considered for percutaneous aortic valve replacement ?J ThoracCardiovascSurg 2008;136:566-71.
  11. Nashef S-A-M, Roques F, Sharples L et al. EUROSCORE II. Eur J CardiothoracSurg 2012;41:734-45.
  12. Chalmers J, Pullan M, Fabri B et al. Validation of EuroSCORE II in a modern cohort of patients undergoing cardiac surgery. Eur J CardiothoracSurg 2012;0:1-7.
  13. Grant S W, Hickey G L, Dimarakis I et al. How does EuroSCORE II perform in UK cardiac surgery; an analysis of 23 740 patients from the Society for Cardiothoracic Surgery in Great Britain and Ireland National Database. Heart 2012;98:1568-72.
  14. Di Deddaa U, Pelisserob G, Agnellia B. Accuracy, calibration and clinical performance of the new EuroSCORE II risk stratification system. Eur J CardiothoracSurg 2013;43: 27-32.
  15. Mestres CA, Castro MA, Bernabeu E et al. Preopeartive risk stratification in infective endocarditis. Does the Euroscore model work? Preliminary results. Eur J CardiothoracSurg 2007;39:281-5.
  16. Rasmussen RV, Bruun LE, Lund J et al. The impact of cardiac surgery in native valve infective endocarditis: Can euroSCORE guide patient selection? Int J Cardiol 2011;149:304-9.
  17. Patrat-Delon S, Rouxel A, Gacouin A, Revest M, Flécher E, Fouquet O et al. EuroSCORE II underestimates mortality after cardiac surgery for infective endocarditis. Eur J CardiothoracSurg 2015; doi:10.1093/ejcts/ezv223.
  18. Marisa DF, Maurizio C, Antonio C et al. The Need for a Specific Risk PredictionSystem in Native Valve Infective Endocarditis Surgery. The Scientific World Journal ; Volume 2012, Article ID 307571, 8 pages doi:10.1100/2012/307571
  19. Manuel MS, Patricia M, Ana A et al. Valve surgery in active infective endocarditis: A simple score to predict in-hospital prognosis. Int.J.cardiol.2015 ;175 :133-137.