The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis
Background: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patie...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/9/1/23 |
| _version_ | 1827371121697095680 |
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| author | Bianca Leal de Almeida Tania Mara Varejao Strabelli Marcio Sommer Bittencourt Vítor Falcão de Oliveira Danielle Menosi Gualandro Alfredo Jose Mansur Flavio Tarasouchi Lucas Pocebon Milena Paixão Flora Goldemberg Reinaldo Salomão Rinaldo Focaccia Siciliano |
| author_facet | Bianca Leal de Almeida Tania Mara Varejao Strabelli Marcio Sommer Bittencourt Vítor Falcão de Oliveira Danielle Menosi Gualandro Alfredo Jose Mansur Flavio Tarasouchi Lucas Pocebon Milena Paixão Flora Goldemberg Reinaldo Salomão Rinaldo Focaccia Siciliano |
| author_sort | Bianca Leal de Almeida |
| collection | DOAJ |
| description | Background: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patients with infective endocarditis. Methods: Between January 2010 and June 2019, 867 patients with suspected left-sided endocarditis were evaluated; 517 were included with left-sided infective endocarditis defined as “possible” or “definite” endocarditis, according to the Modified Duke Criteria. ROC curves were constructed to assess the accuracy of qSOFA and SOFA sepsis scores for the prediction of in-hospital mortality. Results: The median age was 57 years, 65% were male, 435 (84%) had pre-existing heart valve disease, and the overall mortality was 28%. The most frequent etiologies were <i>Streptococcus</i> spp. (36%), <i>Enterococcus</i> spp. (10%), and <i>Staphylococcus aureus</i> (9%). The sepsis scores from the ROC curves used to predict in-hospital mortality were qSOFA 0.601 (CI95% 0.522–0.681) and SOFA score 0.679 (CI95% 0.602–0.756). A sub-group analysis in patients with and without pre-existing valve disease for SOFA ≥ 2 showed ROC curves of 0.627 (CI95% 0.563–0.690) and 0.775 (CI95% 0.594–0.956), respectively. Conclusions: qSOFA and SOFA scores were associated with increased in-hospital mortality in patients with infective endocarditis. However, as accuracy was relatively lower compared to other sites of bacterial infections, we believe that this score may have lower accuracy when predicting the prognosis of patients with IE, because, in this disease, the patient’s death may be more frequently linked to valvular and cardiac dysfunction, as well as embolic events, and less frequently directly associated with sepsis. |
| first_indexed | 2024-03-08T10:33:36Z |
| format | Article |
| id | doaj.art-9c1d2fe245ee4b7c9930b02ccb9572fc |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-08T10:33:36Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-9c1d2fe245ee4b7c9930b02ccb9572fc2024-01-26T18:42:50ZengMDPI AGTropical Medicine and Infectious Disease2414-63662024-01-01912310.3390/tropicalmed9010023The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective EndocarditisBianca Leal de Almeida0Tania Mara Varejao Strabelli1Marcio Sommer Bittencourt2Vítor Falcão de Oliveira3Danielle Menosi Gualandro4Alfredo Jose Mansur5Flavio Tarasouchi6Lucas Pocebon7Milena Paixão8Flora Goldemberg9Reinaldo Salomão10Rinaldo Focaccia Siciliano11Hospital das Clínicas, University of São Paulo Medical School, São Paulo 05403-010, SP, BrazilInstituto do Coracao (InCor) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, BrazilCenter for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-010, SP, BrazilHospital das Clínicas, University of São Paulo Medical School, São Paulo 05403-010, SP, BrazilInstituto do Coracao (InCor) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, BrazilInstituto do Coracao (InCor) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, BrazilInstituto do Coracao (InCor) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, BrazilHospital das Clínicas, University of São Paulo Medical School, São Paulo 05403-010, SP, BrazilInstituto do Coracao (InCor) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, SP, BrazilHospital das Clínicas, University of São Paulo Medical School, São Paulo 05403-010, SP, BrazilEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-900, SP, BrazilHospital das Clínicas, University of São Paulo Medical School, São Paulo 05403-010, SP, BrazilBackground: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patients with infective endocarditis. Methods: Between January 2010 and June 2019, 867 patients with suspected left-sided endocarditis were evaluated; 517 were included with left-sided infective endocarditis defined as “possible” or “definite” endocarditis, according to the Modified Duke Criteria. ROC curves were constructed to assess the accuracy of qSOFA and SOFA sepsis scores for the prediction of in-hospital mortality. Results: The median age was 57 years, 65% were male, 435 (84%) had pre-existing heart valve disease, and the overall mortality was 28%. The most frequent etiologies were <i>Streptococcus</i> spp. (36%), <i>Enterococcus</i> spp. (10%), and <i>Staphylococcus aureus</i> (9%). The sepsis scores from the ROC curves used to predict in-hospital mortality were qSOFA 0.601 (CI95% 0.522–0.681) and SOFA score 0.679 (CI95% 0.602–0.756). A sub-group analysis in patients with and without pre-existing valve disease for SOFA ≥ 2 showed ROC curves of 0.627 (CI95% 0.563–0.690) and 0.775 (CI95% 0.594–0.956), respectively. Conclusions: qSOFA and SOFA scores were associated with increased in-hospital mortality in patients with infective endocarditis. However, as accuracy was relatively lower compared to other sites of bacterial infections, we believe that this score may have lower accuracy when predicting the prognosis of patients with IE, because, in this disease, the patient’s death may be more frequently linked to valvular and cardiac dysfunction, as well as embolic events, and less frequently directly associated with sepsis.https://www.mdpi.com/2414-6366/9/1/23endocarditissepsisSOFAprognosis |
| spellingShingle | Bianca Leal de Almeida Tania Mara Varejao Strabelli Marcio Sommer Bittencourt Vítor Falcão de Oliveira Danielle Menosi Gualandro Alfredo Jose Mansur Flavio Tarasouchi Lucas Pocebon Milena Paixão Flora Goldemberg Reinaldo Salomão Rinaldo Focaccia Siciliano The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis Tropical Medicine and Infectious Disease endocarditis sepsis SOFA prognosis |
| title | The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis |
| title_full | The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis |
| title_fullStr | The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis |
| title_full_unstemmed | The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis |
| title_short | The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis |
| title_sort | predictive value of sepsis scores for in hospital mortality in patients with left sided infective endocarditis |
| topic | endocarditis sepsis SOFA prognosis |
| url | https://www.mdpi.com/2414-6366/9/1/23 |
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