| Title: |
Infective endocarditis: do we have an effective risk score model? A systematic review |
| Authors: |
Rizzo, V; Salmasi, MY; Sabetai, M; Primus, C; Sandoe, J; Lewis, M; Woldman, S; Athanasiou, T |
| Source: |
12 ; 1 |
| Publisher Information: |
Frontiers Media |
| Publication Year: |
2023 |
| Collection: |
Imperial College London: Spiral |
| Description: |
Background Infective 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. Conclusion Despite 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 studies and large comprehensive registries ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
Frontiers in Cardiovascular Medicine; http://hdl.handle.net/10044/1/102899 |
| DOI: |
10.3389/fcvm.2023.1093363 |
| Availability: |
http://hdl.handle.net/10044/1/102899; https://doi.org/10.3389/fcvm.2023.1093363 |
| Rights: |
© 2023 Rizzo, Salmasi, Sabetai, Primus, Sandoe, Lewis, Woldman and Athanasiou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.8AFCD215 |
| Database: |
BASE |