Validated risk score for predicting 6-month mortality in infective endocarditis

Lawrence P. Park, Vivian H. Chu, Gail Peterson, Athanasios Skoutelis, Tatjana Lejko-Zupa, Emilio Bouza, Pierre Tattevin, Gilbert Habib, Ren Tan, Javier Gonzalez, Javier Altclas, Jameela Edathodu, Claudio Querido Fortes, Rinaldo Focaccia Siciliano, Orathai Pachirat, Souha Kanj, Andrew Wang, Liliana Clara, Marisa LSanchez, José Casabé & 231 others Claudia Cortes, Francisco Nacinovich, Pablo Fernandez Oses, Ricardo Ronderos, Adriana Sucari, Jorge Thierer, Denis Spelman, Eugene Athan, Owen Harris, Karina Kennedy, Ren Tan, David Gordon, Lito Papanicolas, Tony Korman, Despina Kotsanas, Robyn Dever, Phillip Jones, Pam Konecny, Richard Lawrence, David Rees, Suzanne Ryan, Michael P. Feneley, John Harkness, Phillip Jones, Suzanne Ryan, Phillip Jones, Suzanne Ryan, Phillip Jones, Jeffrey Post, Porl Reinbott, Suzanne Ryan, Rainer Gattringer, Franz Wiesbauer, Adriana Ribas Andrade, Ana Cláudia Passos de Brito, Armenio Costa Guimarães, Regina Aparecida de Medeiros Tranchesi, Marcelo Goulart Paiva, Claudio Querido Fortes, Auristela de Oliveira Ramos, Clara Weksler, Giovanna Ferraiuoli, Wilma Golebiovski, Cristiane Lamas, A. Karlowsky James, Yoav Keynan, Andrew M. Morris, Ethan Rubinstein, Sandra Braun Jones, Patricia Garcia, M. Cereceda, Alberto Fica, Rodrigo Montagna Mella, Ricardo Fernandez, Liliana Franco, Javier Gonzalez, Astrid Natalia Jaramillo, Bruno Barsic, Suzana Bukovski, Vladimir Krajinovic, Ana Pangercic, Igor Rudez, Josip Vincelj, Tomas Freiberger, Jiri Pol, Barbora Zaloudikova, Zainab Ashour, Amani El Kholy, Marwa Mishaal, Dina Osama, Hussien Rizk, Neijla Aissa, Corentine Alauzet, Francois Alla, Chu Catherine Campagnac, Thanh Doco-Lecompte, Christine Selton-Suty, Francois Delahaye, Armelle Delahaye, Francois Vandenesch, Erwan Donal, Pierre Yves Donnio, Erwan Flecher, Christian Michelet, Matthieu Revest, Pierre Tattevin, Florent Chevalier, Antoine Jeu, Jean Paul Remadi, Dan Rusinaru, Christophe Tribouilloy, Yvette Bernard, Catherine Chirouze, Bruno Hoen, Joel Leroy, Patrick Plesiat, Christoph Naber, Carl Neuerburg, Bahram Mazaheri, Christoph Naber, Carl Neuerburg, Sophia Athanasia, Ioannis Deliolanis, Helen Giamarellou, Tsaganos Thomas, Efthymia Giannitsioti, Elena Mylona, Olga Paniara, Konstantinos Papanicolaou, John Pyros, Athanasios Skoutelis, Gautam Sharma, Johnson Francis, Lathi Nair, Vinod Thomas, Krishnan Venugopal, Margaret M. Hannan, John P. Hurley, Amos Cahan, Dan Gilon, Sarah Israel, Maya Korem, Jacob Strahilevitz, Ethan Rubinstein, Jacob Strahilevitz, Emanuele Durante-Mangoni, Irene Mattucci, Daniela Pinto, Federica Agrusta, Alessandra Senese, Enrico Ragone, Riccardo Utili, Enrico Cecchi, Francesco De Rosa, Davide Forno, Massimo Imazio, Rita Trinchero, Paolo Grossi, Mariangela Lattanzio, Antonio Toniolo, Antonio Goglio, Annibale Raglio, Veronica Ravasio, Marco Rizzi, Fredy Suter, Giampiero Carosi, Silvia Magri, Liana Signorini, Imran Abidin, Syahidah Syed Tamin, Eduardo Rivera Martinez, Gabriel Israel Soto Nieto, Jan T.M.van der Meer, Stephen Chambers, David Holland, Arthur Morris, Nigel Raymond, Kerry Read, David R. Murdoch, Stefan Dragulescu, Adina Ionac, Cristian Mornos, O. M. Butkevich, Natalia Chipigina, Ozerecky Kirill, Kulichenko Vadim, Tatiana Vinogradova, Yee Yun Liew, Ru San Tan, Tatjana Lejko-Zupanc, Mateja Logar, Manica Mueller-Premru, Patrick Commerford, Anita Commerford, Eduan Deetlefs, Cass Hansa, Mpiko Ntsekhe, Manuel Almela, Yolanda Armero, Manuel Azqueta, Ximena Castañeda, Carlos Cervera, Carlos Falces, Cristina Garcia-de-la-Maria, Guillermina Fita, Jose M. Gatell, Magda Heras, Jaime Llopis, Francesc Marco, Carlos A. Mestres, Jose M. Miro, Asuncion Moreno, Salvador Ninot, Carlos Pare, Juan M. Pericas, Jose Ramirez, Irene Rovira, Marta Sitges, Ignasi Anguera, Bernat Font, Joan Raimon Guma, Benito Almirante, Nuria Fernandez-Hidalgo, Pilar Tornos, Aristides de Alarcon, Ricardo Parra, Eric Alestig, Magnus Johansson, Lars Olaison, Ulrika Snygg-Martin, Anna Casey, Tom Elliott, Peter Lambert, Richard Watkin, Christina Eyton, John L. Klein, Suzanne Bradley, Carol Kauffman, Roger Bedimo, Stamatios Lerakis, Robert Cantey, Lisa Steed, Dannah Wray, A. Dickerman Stuart, Hector Bonilla, Joseph DiPersio, Sara Jane Salstrom, John Baddley, Mukesh Patel, Donald Levine, for the International Collaboration on Endocarditis (ICE) Investigators

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background-Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Methods and Results-Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0%) in the ICE-PCS cohort and 342 of 1197 (28.6%) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions-Six-month mortality after IE is 25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.

Original languageEnglish
Article numbere003016
JournalJournal of the American Heart Association
Volume5
Issue number4
DOIs
Publication statusPublished - 2016
Externally publishedYes

Keywords

  • Infection
  • Mortality
  • Prognosis
  • Surgery
  • Valves

Cite this

Park, L. P., Chu, V. H., Peterson, G., Skoutelis, A., Lejko-Zupa, T., Bouza, E., ... for the International Collaboration on Endocarditis (ICE) Investigators (2016). Validated risk score for predicting 6-month mortality in infective endocarditis. Journal of the American Heart Association, 5(4), [e003016]. https://doi.org/10.1161/JAHA.115.003016
Park, Lawrence P. ; Chu, Vivian H. ; Peterson, Gail ; Skoutelis, Athanasios ; Lejko-Zupa, Tatjana ; Bouza, Emilio ; Tattevin, Pierre ; Habib, Gilbert ; Tan, Ren ; Gonzalez, Javier ; Altclas, Javier ; Edathodu, Jameela ; Fortes, Claudio Querido ; Siciliano, Rinaldo Focaccia ; Pachirat, Orathai ; Kanj, Souha ; Wang, Andrew ; Clara, Liliana ; LSanchez, Marisa ; Casabé, José ; Cortes, Claudia ; Nacinovich, Francisco ; Oses, Pablo Fernandez ; Ronderos, Ricardo ; Sucari, Adriana ; Thierer, Jorge ; Spelman, Denis ; Athan, Eugene ; Harris, Owen ; Kennedy, Karina ; Tan, Ren ; Gordon, David ; Papanicolas, Lito ; Korman, Tony ; Kotsanas, Despina ; Dever, Robyn ; Jones, Phillip ; Konecny, Pam ; Lawrence, Richard ; Rees, David ; Ryan, Suzanne ; Feneley, Michael P. ; Harkness, John ; Jones, Phillip ; Ryan, Suzanne ; Jones, Phillip ; Ryan, Suzanne ; Jones, Phillip ; Post, Jeffrey ; Reinbott, Porl ; Ryan, Suzanne ; Gattringer, Rainer ; Wiesbauer, Franz ; Andrade, Adriana Ribas ; de Brito, Ana Cláudia Passos ; Guimarães, Armenio Costa ; Tranchesi, Regina Aparecida de Medeiros ; Paiva, Marcelo Goulart ; Fortes, Claudio Querido ; Ramos, Auristela de Oliveira ; Weksler, Clara ; Ferraiuoli, Giovanna ; Golebiovski, Wilma ; Lamas, Cristiane ; James, A. Karlowsky ; Keynan, Yoav ; Morris, Andrew M. ; Rubinstein, Ethan ; Jones, Sandra Braun ; Garcia, Patricia ; Cereceda, M. ; Fica, Alberto ; Mella, Rodrigo Montagna ; Fernandez, Ricardo ; Franco, Liliana ; Gonzalez, Javier ; Jaramillo, Astrid Natalia ; Barsic, Bruno ; Bukovski, Suzana ; Krajinovic, Vladimir ; Pangercic, Ana ; Rudez, Igor ; Vincelj, Josip ; Freiberger, Tomas ; Pol, Jiri ; Zaloudikova, Barbora ; Ashour, Zainab ; Kholy, Amani El ; Mishaal, Marwa ; Osama, Dina ; Rizk, Hussien ; Aissa, Neijla ; Alauzet, Corentine ; Alla, Francois ; Campagnac, Chu Catherine ; Doco-Lecompte, Thanh ; Selton-Suty, Christine ; Delahaye, Francois ; Delahaye, Armelle ; Vandenesch, Francois ; Donal, Erwan ; Donnio, Pierre Yves ; Flecher, Erwan ; Michelet, Christian ; Revest, Matthieu ; Tattevin, Pierre ; Chevalier, Florent ; Jeu, Antoine ; Remadi, Jean Paul ; Rusinaru, Dan ; Tribouilloy, Christophe ; Bernard, Yvette ; Chirouze, Catherine ; Hoen, Bruno ; Leroy, Joel ; Plesiat, Patrick ; Naber, Christoph ; Neuerburg, Carl ; Mazaheri, Bahram ; Naber, Christoph ; Neuerburg, Carl ; Athanasia, Sophia ; Deliolanis, Ioannis ; Giamarellou, Helen ; Thomas, Tsaganos ; Giannitsioti, Efthymia ; Mylona, Elena ; Paniara, Olga ; Papanicolaou, Konstantinos ; Pyros, John ; Skoutelis, Athanasios ; Sharma, Gautam ; Francis, Johnson ; Nair, Lathi ; Thomas, Vinod ; Venugopal, Krishnan ; Hannan, Margaret M. ; Hurley, John P. ; Cahan, Amos ; Gilon, Dan ; Israel, Sarah ; Korem, Maya ; Strahilevitz, Jacob ; Rubinstein, Ethan ; Strahilevitz, Jacob ; Durante-Mangoni, Emanuele ; Mattucci, Irene ; Pinto, Daniela ; Agrusta, Federica ; Senese, Alessandra ; Ragone, Enrico ; Utili, Riccardo ; Cecchi, Enrico ; Rosa, Francesco De ; Forno, Davide ; Imazio, Massimo ; Trinchero, Rita ; Grossi, Paolo ; Lattanzio, Mariangela ; Toniolo, Antonio ; Goglio, Antonio ; Raglio, Annibale ; Ravasio, Veronica ; Rizzi, Marco ; Suter, Fredy ; Carosi, Giampiero ; Magri, Silvia ; Signorini, Liana ; Abidin, Imran ; Tamin, Syahidah Syed ; Martinez, Eduardo Rivera ; Nieto, Gabriel Israel Soto ; Meer, Jan T.M.van der ; Chambers, Stephen ; Holland, David ; Morris, Arthur ; Raymond, Nigel ; Read, Kerry ; Murdoch, David R. ; Dragulescu, Stefan ; Ionac, Adina ; Mornos, Cristian ; Butkevich, O. M. ; Chipigina, Natalia ; Kirill, Ozerecky ; Vadim, Kulichenko ; Vinogradova, Tatiana ; Liew, Yee Yun ; Tan, Ru San ; Lejko-Zupanc, Tatjana ; Logar, Mateja ; Mueller-Premru, Manica ; Commerford, Patrick ; Commerford, Anita ; Deetlefs, Eduan ; Hansa, Cass ; Ntsekhe, Mpiko ; Almela, Manuel ; Armero, Yolanda ; Azqueta, Manuel ; Castañeda, Ximena ; Cervera, Carlos ; Falces, Carlos ; Garcia-de-la-Maria, Cristina ; Fita, Guillermina ; Gatell, Jose M. ; Heras, Magda ; Llopis, Jaime ; Marco, Francesc ; Mestres, Carlos A. ; Miro, Jose M. ; Moreno, Asuncion ; Ninot, Salvador ; Pare, Carlos ; Pericas, Juan M. ; Ramirez, Jose ; Rovira, Irene ; Sitges, Marta ; Anguera, Ignasi ; Font, Bernat ; Guma, Joan Raimon ; Almirante, Benito ; Fernandez-Hidalgo, Nuria ; Tornos, Pilar ; Alarcon, Aristides de ; Parra, Ricardo ; Alestig, Eric ; Johansson, Magnus ; Olaison, Lars ; Snygg-Martin, Ulrika ; Casey, Anna ; Elliott, Tom ; Lambert, Peter ; Watkin, Richard ; Eyton, Christina ; Klein, John L. ; Bradley, Suzanne ; Kauffman, Carol ; Bedimo, Roger ; Lerakis, Stamatios ; Cantey, Robert ; Steed, Lisa ; Wray, Dannah ; Stuart, A. Dickerman ; Bonilla, Hector ; DiPersio, Joseph ; Salstrom, Sara Jane ; Baddley, John ; Patel, Mukesh ; Levine, Donald ; for the International Collaboration on Endocarditis (ICE) Investigators. / Validated risk score for predicting 6-month mortality in infective endocarditis. In: Journal of the American Heart Association. 2016 ; Vol. 5, No. 4.
@article{041405be41ea461fba68ed16d0f5187b,
title = "Validated risk score for predicting 6-month mortality in infective endocarditis",
abstract = "Background-Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Methods and Results-Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0{\%}) in the ICE-PCS cohort and 342 of 1197 (28.6{\%}) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1{\%} and 54.0{\%} of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95{\%} CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions-Six-month mortality after IE is 25{\%} and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.",
keywords = "Infection, Mortality, Prognosis, Surgery, Valves",
author = "Park, {Lawrence P.} and Chu, {Vivian H.} and Gail Peterson and Athanasios Skoutelis and Tatjana Lejko-Zupa and Emilio Bouza and Pierre Tattevin and Gilbert Habib and Ren Tan and Javier Gonzalez and Javier Altclas and Jameela Edathodu and Fortes, {Claudio Querido} and Siciliano, {Rinaldo Focaccia} and Orathai Pachirat and Souha Kanj and Andrew Wang and Liliana Clara and Marisa LSanchez and Jos{\'e} Casab{\'e} and Claudia Cortes and Francisco Nacinovich and Oses, {Pablo Fernandez} and Ricardo Ronderos and Adriana Sucari and Jorge Thierer and Denis Spelman and Eugene Athan and Owen Harris and Karina Kennedy and Ren Tan and David Gordon and Lito Papanicolas and Tony Korman and Despina Kotsanas and Robyn Dever and Phillip Jones and Pam Konecny and Richard Lawrence and David Rees and Suzanne Ryan and Feneley, {Michael P.} and John Harkness and Phillip Jones and Suzanne Ryan and Phillip Jones and Suzanne Ryan and Phillip Jones and Jeffrey Post and Porl Reinbott and Suzanne Ryan and Rainer Gattringer and Franz Wiesbauer and Andrade, {Adriana Ribas} and {de Brito}, {Ana Cl{\'a}udia Passos} and Guimar{\~a}es, {Armenio Costa} and Tranchesi, {Regina Aparecida de Medeiros} and Paiva, {Marcelo Goulart} and Fortes, {Claudio Querido} and Ramos, {Auristela de Oliveira} and Clara Weksler and Giovanna Ferraiuoli and Wilma Golebiovski and Cristiane Lamas and James, {A. Karlowsky} and Yoav Keynan and Morris, {Andrew M.} and Ethan Rubinstein and Jones, {Sandra Braun} and Patricia Garcia and M. Cereceda and Alberto Fica and Mella, {Rodrigo Montagna} and Ricardo Fernandez and Liliana Franco and Javier Gonzalez and Jaramillo, {Astrid Natalia} and Bruno Barsic and Suzana Bukovski and Vladimir Krajinovic and Ana Pangercic and Igor Rudez and Josip Vincelj and Tomas Freiberger and Jiri Pol and Barbora Zaloudikova and Zainab Ashour and Kholy, {Amani El} and Marwa Mishaal and Dina Osama and Hussien Rizk and Neijla Aissa and Corentine Alauzet and Francois Alla and Campagnac, {Chu Catherine} and Thanh Doco-Lecompte and Christine Selton-Suty and Francois Delahaye and Armelle Delahaye and Francois Vandenesch and Erwan Donal and Donnio, {Pierre Yves} and Erwan Flecher and Christian Michelet and Matthieu Revest and Pierre Tattevin and Florent Chevalier and Antoine Jeu and Remadi, {Jean Paul} and Dan Rusinaru and Christophe Tribouilloy and Yvette Bernard and Catherine Chirouze and Bruno Hoen and Joel Leroy and Patrick Plesiat and Christoph Naber and Carl Neuerburg and Bahram Mazaheri and Christoph Naber and Carl Neuerburg and Sophia Athanasia and Ioannis Deliolanis and Helen Giamarellou and Tsaganos Thomas and Efthymia Giannitsioti and Elena Mylona and Olga Paniara and Konstantinos Papanicolaou and John Pyros and Athanasios Skoutelis and Gautam Sharma and Johnson Francis and Lathi Nair and Vinod Thomas and Krishnan Venugopal and Hannan, {Margaret M.} and Hurley, {John P.} and Amos Cahan and Dan Gilon and Sarah Israel and Maya Korem and Jacob Strahilevitz and Ethan Rubinstein and Jacob Strahilevitz and Emanuele Durante-Mangoni and Irene Mattucci and Daniela Pinto and Federica Agrusta and Alessandra Senese and Enrico Ragone and Riccardo Utili and Enrico Cecchi and Rosa, {Francesco De} and Davide Forno and Massimo Imazio and Rita Trinchero and Paolo Grossi and Mariangela Lattanzio and Antonio Toniolo and Antonio Goglio and Annibale Raglio and Veronica Ravasio and Marco Rizzi and Fredy Suter and Giampiero Carosi and Silvia Magri and Liana Signorini and Imran Abidin and Tamin, {Syahidah Syed} and Martinez, {Eduardo Rivera} and Nieto, {Gabriel Israel Soto} and Meer, {Jan T.M.van der} and Stephen Chambers and David Holland and Arthur Morris and Nigel Raymond and Kerry Read and Murdoch, {David R.} and Stefan Dragulescu and Adina Ionac and Cristian Mornos and Butkevich, {O. M.} and Natalia Chipigina and Ozerecky Kirill and Kulichenko Vadim and Tatiana Vinogradova and Liew, {Yee Yun} and Tan, {Ru San} and Tatjana Lejko-Zupanc and Mateja Logar and Manica Mueller-Premru and Patrick Commerford and Anita Commerford and Eduan Deetlefs and Cass Hansa and Mpiko Ntsekhe and Manuel Almela and Yolanda Armero and Manuel Azqueta and Ximena Casta{\~n}eda and Carlos Cervera and Carlos Falces and Cristina Garcia-de-la-Maria and Guillermina Fita and Gatell, {Jose M.} and Magda Heras and Jaime Llopis and Francesc Marco and Mestres, {Carlos A.} and Miro, {Jose M.} and Asuncion Moreno and Salvador Ninot and Carlos Pare and Pericas, {Juan M.} and Jose Ramirez and Irene Rovira and Marta Sitges and Ignasi Anguera and Bernat Font and Guma, {Joan Raimon} and Benito Almirante and Nuria Fernandez-Hidalgo and Pilar Tornos and Alarcon, {Aristides de} and Ricardo Parra and Eric Alestig and Magnus Johansson and Lars Olaison and Ulrika Snygg-Martin and Anna Casey and Tom Elliott and Peter Lambert and Richard Watkin and Christina Eyton and Klein, {John L.} and Suzanne Bradley and Carol Kauffman and Roger Bedimo and Stamatios Lerakis and Robert Cantey and Lisa Steed and Dannah Wray and Stuart, {A. Dickerman} and Hector Bonilla and Joseph DiPersio and Salstrom, {Sara Jane} and John Baddley and Mukesh Patel and Donald Levine and {for the International Collaboration on Endocarditis (ICE) Investigators}",
year = "2016",
doi = "10.1161/JAHA.115.003016",
language = "English",
volume = "5",
journal = "American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease",
issn = "2047-9980",
publisher = "American Heart Association, Inc.",
number = "4",

}

Park, LP, Chu, VH, Peterson, G, Skoutelis, A, Lejko-Zupa, T, Bouza, E, Tattevin, P, Habib, G, Tan, R, Gonzalez, J, Altclas, J, Edathodu, J, Fortes, CQ, Siciliano, RF, Pachirat, O, Kanj, S, Wang, A, Clara, L, LSanchez, M, Casabé, J, Cortes, C, Nacinovich, F, Oses, PF, Ronderos, R, Sucari, A, Thierer, J, Spelman, D, Athan, E, Harris, O, Kennedy, K, Tan, R, Gordon, D, Papanicolas, L, Korman, T, Kotsanas, D, Dever, R, Jones, P, Konecny, P, Lawrence, R, Rees, D, Ryan, S, Feneley, MP, Harkness, J, Jones, P, Ryan, S, Jones, P, Ryan, S, Jones, P, Post, J, Reinbott, P, Ryan, S, Gattringer, R, Wiesbauer, F, Andrade, AR, de Brito, ACP, Guimarães, AC, Tranchesi, RADM, Paiva, MG, Fortes, CQ, Ramos, ADO, Weksler, C, Ferraiuoli, G, Golebiovski, W, Lamas, C, James, AK, Keynan, Y, Morris, AM, Rubinstein, E, Jones, SB, Garcia, P, Cereceda, M, Fica, A, Mella, RM, Fernandez, R, Franco, L, Gonzalez, J, Jaramillo, AN, Barsic, B, Bukovski, S, Krajinovic, V, Pangercic, A, Rudez, I, Vincelj, J, Freiberger, T, Pol, J, Zaloudikova, B, Ashour, Z, Kholy, AE, Mishaal, M, Osama, D, Rizk, H, Aissa, N, Alauzet, C, Alla, F, Campagnac, CC, Doco-Lecompte, T, Selton-Suty, C, Delahaye, F, Delahaye, A, Vandenesch, F, Donal, E, Donnio, PY, Flecher, E, Michelet, C, Revest, M, Tattevin, P, Chevalier, F, Jeu, A, Remadi, JP, Rusinaru, D, Tribouilloy, C, Bernard, Y, Chirouze, C, Hoen, B, Leroy, J, Plesiat, P, Naber, C, Neuerburg, C, Mazaheri, B, Naber, C, Neuerburg, C, Athanasia, S, Deliolanis, I, Giamarellou, H, Thomas, T, Giannitsioti, E, Mylona, E, Paniara, O, Papanicolaou, K, Pyros, J, Skoutelis, A, Sharma, G, Francis, J, Nair, L, Thomas, V, Venugopal, K, Hannan, MM, Hurley, JP, Cahan, A, Gilon, D, Israel, S, Korem, M, Strahilevitz, J, Rubinstein, E, Strahilevitz, J, Durante-Mangoni, E, Mattucci, I, Pinto, D, Agrusta, F, Senese, A, Ragone, E, Utili, R, Cecchi, E, Rosa, FD, Forno, D, Imazio, M, Trinchero, R, Grossi, P, Lattanzio, M, Toniolo, A, Goglio, A, Raglio, A, Ravasio, V, Rizzi, M, Suter, F, Carosi, G, Magri, S, Signorini, L, Abidin, I, Tamin, SS, Martinez, ER, Nieto, GIS, Meer, JTMVD, Chambers, S, Holland, D, Morris, A, Raymond, N, Read, K, Murdoch, DR, Dragulescu, S, Ionac, A, Mornos, C, Butkevich, OM, Chipigina, N, Kirill, O, Vadim, K, Vinogradova, T, Liew, YY, Tan, RS, Lejko-Zupanc, T, Logar, M, Mueller-Premru, M, Commerford, P, Commerford, A, Deetlefs, E, Hansa, C, Ntsekhe, M, Almela, M, Armero, Y, Azqueta, M, Castañeda, X, Cervera, C, Falces, C, Garcia-de-la-Maria, C, Fita, G, Gatell, JM, Heras, M, Llopis, J, Marco, F, Mestres, CA, Miro, JM, Moreno, A, Ninot, S, Pare, C, Pericas, JM, Ramirez, J, Rovira, I, Sitges, M, Anguera, I, Font, B, Guma, JR, Almirante, B, Fernandez-Hidalgo, N, Tornos, P, Alarcon, AD, Parra, R, Alestig, E, Johansson, M, Olaison, L, Snygg-Martin, U, Casey, A, Elliott, T, Lambert, P, Watkin, R, Eyton, C, Klein, JL, Bradley, S, Kauffman, C, Bedimo, R, Lerakis, S, Cantey, R, Steed, L, Wray, D, Stuart, AD, Bonilla, H, DiPersio, J, Salstrom, SJ, Baddley, J, Patel, M, Levine, D & for the International Collaboration on Endocarditis (ICE) Investigators 2016, 'Validated risk score for predicting 6-month mortality in infective endocarditis' Journal of the American Heart Association, vol. 5, no. 4, e003016. https://doi.org/10.1161/JAHA.115.003016

Validated risk score for predicting 6-month mortality in infective endocarditis. / Park, Lawrence P.; Chu, Vivian H.; Peterson, Gail; Skoutelis, Athanasios; Lejko-Zupa, Tatjana; Bouza, Emilio; Tattevin, Pierre; Habib, Gilbert; Tan, Ren; Gonzalez, Javier; Altclas, Javier; Edathodu, Jameela; Fortes, Claudio Querido; Siciliano, Rinaldo Focaccia; Pachirat, Orathai; Kanj, Souha; Wang, Andrew; Clara, Liliana; LSanchez, Marisa; Casabé, José; Cortes, Claudia; Nacinovich, Francisco; Oses, Pablo Fernandez; Ronderos, Ricardo; Sucari, Adriana; Thierer, Jorge; Spelman, Denis; Athan, Eugene; Harris, Owen; Kennedy, Karina; Tan, Ren; Gordon, David; Papanicolas, Lito; Korman, Tony; Kotsanas, Despina; Dever, Robyn; Jones, Phillip; Konecny, Pam; Lawrence, Richard; Rees, David; Ryan, Suzanne; Feneley, Michael P.; Harkness, John; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Ryan, Suzanne; Jones, Phillip; Post, Jeffrey; Reinbott, Porl; Ryan, Suzanne; Gattringer, Rainer; Wiesbauer, Franz; Andrade, Adriana Ribas; de Brito, Ana Cláudia Passos; Guimarães, Armenio Costa; Tranchesi, Regina Aparecida de Medeiros; Paiva, Marcelo Goulart; Fortes, Claudio Querido; Ramos, Auristela de Oliveira; Weksler, Clara; Ferraiuoli, Giovanna; Golebiovski, Wilma; Lamas, Cristiane; James, A. Karlowsky; Keynan, Yoav; Morris, Andrew M.; Rubinstein, Ethan; Jones, Sandra Braun; Garcia, Patricia; Cereceda, M.; Fica, Alberto; Mella, Rodrigo Montagna; Fernandez, Ricardo; Franco, Liliana; Gonzalez, Javier; Jaramillo, Astrid Natalia; Barsic, Bruno; Bukovski, Suzana; Krajinovic, Vladimir; Pangercic, Ana; Rudez, Igor; Vincelj, Josip; Freiberger, Tomas; Pol, Jiri; Zaloudikova, Barbora; Ashour, Zainab; Kholy, Amani El; Mishaal, Marwa; Osama, Dina; Rizk, Hussien; Aissa, Neijla; Alauzet, Corentine; Alla, Francois; Campagnac, Chu Catherine; Doco-Lecompte, Thanh; Selton-Suty, Christine; Delahaye, Francois; Delahaye, Armelle; Vandenesch, Francois; Donal, Erwan; Donnio, Pierre Yves; Flecher, Erwan; Michelet, Christian; Revest, Matthieu; Tattevin, Pierre; Chevalier, Florent; Jeu, Antoine; Remadi, Jean Paul; Rusinaru, Dan; Tribouilloy, Christophe; Bernard, Yvette; Chirouze, Catherine; Hoen, Bruno; Leroy, Joel; Plesiat, Patrick; Naber, Christoph; Neuerburg, Carl; Mazaheri, Bahram; Naber, Christoph; Neuerburg, Carl; Athanasia, Sophia; Deliolanis, Ioannis; Giamarellou, Helen; Thomas, Tsaganos; Giannitsioti, Efthymia; Mylona, Elena; Paniara, Olga; Papanicolaou, Konstantinos; Pyros, John; Skoutelis, Athanasios; Sharma, Gautam; Francis, Johnson; Nair, Lathi; Thomas, Vinod; Venugopal, Krishnan; Hannan, Margaret M.; Hurley, John P.; Cahan, Amos; Gilon, Dan; Israel, Sarah; Korem, Maya; Strahilevitz, Jacob; Rubinstein, Ethan; Strahilevitz, Jacob; Durante-Mangoni, Emanuele; Mattucci, Irene; Pinto, Daniela; Agrusta, Federica; Senese, Alessandra; Ragone, Enrico; Utili, Riccardo; Cecchi, Enrico; Rosa, Francesco De; Forno, Davide; Imazio, Massimo; Trinchero, Rita; Grossi, Paolo; Lattanzio, Mariangela; Toniolo, Antonio; Goglio, Antonio; Raglio, Annibale; Ravasio, Veronica; Rizzi, Marco; Suter, Fredy; Carosi, Giampiero; Magri, Silvia; Signorini, Liana; Abidin, Imran; Tamin, Syahidah Syed; Martinez, Eduardo Rivera; Nieto, Gabriel Israel Soto; Meer, Jan T.M.van der; Chambers, Stephen; Holland, David; Morris, Arthur; Raymond, Nigel; Read, Kerry; Murdoch, David R.; Dragulescu, Stefan; Ionac, Adina; Mornos, Cristian; Butkevich, O. M.; Chipigina, Natalia; Kirill, Ozerecky; Vadim, Kulichenko; Vinogradova, Tatiana; Liew, Yee Yun; Tan, Ru San; Lejko-Zupanc, Tatjana; Logar, Mateja; Mueller-Premru, Manica; Commerford, Patrick; Commerford, Anita; Deetlefs, Eduan; Hansa, Cass; Ntsekhe, Mpiko; Almela, Manuel; Armero, Yolanda; Azqueta, Manuel; Castañeda, Ximena; Cervera, Carlos; Falces, Carlos; Garcia-de-la-Maria, Cristina; Fita, Guillermina; Gatell, Jose M.; Heras, Magda; Llopis, Jaime; Marco, Francesc; Mestres, Carlos A.; Miro, Jose M.; Moreno, Asuncion; Ninot, Salvador; Pare, Carlos; Pericas, Juan M.; Ramirez, Jose; Rovira, Irene; Sitges, Marta; Anguera, Ignasi; Font, Bernat; Guma, Joan Raimon; Almirante, Benito; Fernandez-Hidalgo, Nuria; Tornos, Pilar; Alarcon, Aristides de; Parra, Ricardo; Alestig, Eric; Johansson, Magnus; Olaison, Lars; Snygg-Martin, Ulrika; Casey, Anna; Elliott, Tom; Lambert, Peter; Watkin, Richard; Eyton, Christina; Klein, John L.; Bradley, Suzanne; Kauffman, Carol; Bedimo, Roger; Lerakis, Stamatios; Cantey, Robert; Steed, Lisa; Wray, Dannah; Stuart, A. Dickerman; Bonilla, Hector; DiPersio, Joseph; Salstrom, Sara Jane; Baddley, John; Patel, Mukesh; Levine, Donald; for the International Collaboration on Endocarditis (ICE) Investigators.

In: Journal of the American Heart Association, Vol. 5, No. 4, e003016, 2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Validated risk score for predicting 6-month mortality in infective endocarditis

AU - Park, Lawrence P.

AU - Chu, Vivian H.

AU - Peterson, Gail

AU - Skoutelis, Athanasios

AU - Lejko-Zupa, Tatjana

AU - Bouza, Emilio

AU - Tattevin, Pierre

AU - Habib, Gilbert

AU - Tan, Ren

AU - Gonzalez, Javier

AU - Altclas, Javier

AU - Edathodu, Jameela

AU - Fortes, Claudio Querido

AU - Siciliano, Rinaldo Focaccia

AU - Pachirat, Orathai

AU - Kanj, Souha

AU - Wang, Andrew

AU - Clara, Liliana

AU - LSanchez, Marisa

AU - Casabé, José

AU - Cortes, Claudia

AU - Nacinovich, Francisco

AU - Oses, Pablo Fernandez

AU - Ronderos, Ricardo

AU - Sucari, Adriana

AU - Thierer, Jorge

AU - Spelman, Denis

AU - Athan, Eugene

AU - Harris, Owen

AU - Kennedy, Karina

AU - Tan, Ren

AU - Gordon, David

AU - Papanicolas, Lito

AU - Korman, Tony

AU - Kotsanas, Despina

AU - Dever, Robyn

AU - Jones, Phillip

AU - Konecny, Pam

AU - Lawrence, Richard

AU - Rees, David

AU - Ryan, Suzanne

AU - Feneley, Michael P.

AU - Harkness, John

AU - Jones, Phillip

AU - Ryan, Suzanne

AU - Jones, Phillip

AU - Ryan, Suzanne

AU - Jones, Phillip

AU - Post, Jeffrey

AU - Reinbott, Porl

AU - Ryan, Suzanne

AU - Gattringer, Rainer

AU - Wiesbauer, Franz

AU - Andrade, Adriana Ribas

AU - de Brito, Ana Cláudia Passos

AU - Guimarães, Armenio Costa

AU - Tranchesi, Regina Aparecida de Medeiros

AU - Paiva, Marcelo Goulart

AU - Fortes, Claudio Querido

AU - Ramos, Auristela de Oliveira

AU - Weksler, Clara

AU - Ferraiuoli, Giovanna

AU - Golebiovski, Wilma

AU - Lamas, Cristiane

AU - James, A. Karlowsky

AU - Keynan, Yoav

AU - Morris, Andrew M.

AU - Rubinstein, Ethan

AU - Jones, Sandra Braun

AU - Garcia, Patricia

AU - Cereceda, M.

AU - Fica, Alberto

AU - Mella, Rodrigo Montagna

AU - Fernandez, Ricardo

AU - Franco, Liliana

AU - Gonzalez, Javier

AU - Jaramillo, Astrid Natalia

AU - Barsic, Bruno

AU - Bukovski, Suzana

AU - Krajinovic, Vladimir

AU - Pangercic, Ana

AU - Rudez, Igor

AU - Vincelj, Josip

AU - Freiberger, Tomas

AU - Pol, Jiri

AU - Zaloudikova, Barbora

AU - Ashour, Zainab

AU - Kholy, Amani El

AU - Mishaal, Marwa

AU - Osama, Dina

AU - Rizk, Hussien

AU - Aissa, Neijla

AU - Alauzet, Corentine

AU - Alla, Francois

AU - Campagnac, Chu Catherine

AU - Doco-Lecompte, Thanh

AU - Selton-Suty, Christine

AU - Delahaye, Francois

AU - Delahaye, Armelle

AU - Vandenesch, Francois

AU - Donal, Erwan

AU - Donnio, Pierre Yves

AU - Flecher, Erwan

AU - Michelet, Christian

AU - Revest, Matthieu

AU - Tattevin, Pierre

AU - Chevalier, Florent

AU - Jeu, Antoine

AU - Remadi, Jean Paul

AU - Rusinaru, Dan

AU - Tribouilloy, Christophe

AU - Bernard, Yvette

AU - Chirouze, Catherine

AU - Hoen, Bruno

AU - Leroy, Joel

AU - Plesiat, Patrick

AU - Naber, Christoph

AU - Neuerburg, Carl

AU - Mazaheri, Bahram

AU - Naber, Christoph

AU - Neuerburg, Carl

AU - Athanasia, Sophia

AU - Deliolanis, Ioannis

AU - Giamarellou, Helen

AU - Thomas, Tsaganos

AU - Giannitsioti, Efthymia

AU - Mylona, Elena

AU - Paniara, Olga

AU - Papanicolaou, Konstantinos

AU - Pyros, John

AU - Skoutelis, Athanasios

AU - Sharma, Gautam

AU - Francis, Johnson

AU - Nair, Lathi

AU - Thomas, Vinod

AU - Venugopal, Krishnan

AU - Hannan, Margaret M.

AU - Hurley, John P.

AU - Cahan, Amos

AU - Gilon, Dan

AU - Israel, Sarah

AU - Korem, Maya

AU - Strahilevitz, Jacob

AU - Rubinstein, Ethan

AU - Strahilevitz, Jacob

AU - Durante-Mangoni, Emanuele

AU - Mattucci, Irene

AU - Pinto, Daniela

AU - Agrusta, Federica

AU - Senese, Alessandra

AU - Ragone, Enrico

AU - Utili, Riccardo

AU - Cecchi, Enrico

AU - Rosa, Francesco De

AU - Forno, Davide

AU - Imazio, Massimo

AU - Trinchero, Rita

AU - Grossi, Paolo

AU - Lattanzio, Mariangela

AU - Toniolo, Antonio

AU - Goglio, Antonio

AU - Raglio, Annibale

AU - Ravasio, Veronica

AU - Rizzi, Marco

AU - Suter, Fredy

AU - Carosi, Giampiero

AU - Magri, Silvia

AU - Signorini, Liana

AU - Abidin, Imran

AU - Tamin, Syahidah Syed

AU - Martinez, Eduardo Rivera

AU - Nieto, Gabriel Israel Soto

AU - Meer, Jan T.M.van der

AU - Chambers, Stephen

AU - Holland, David

AU - Morris, Arthur

AU - Raymond, Nigel

AU - Read, Kerry

AU - Murdoch, David R.

AU - Dragulescu, Stefan

AU - Ionac, Adina

AU - Mornos, Cristian

AU - Butkevich, O. M.

AU - Chipigina, Natalia

AU - Kirill, Ozerecky

AU - Vadim, Kulichenko

AU - Vinogradova, Tatiana

AU - Liew, Yee Yun

AU - Tan, Ru San

AU - Lejko-Zupanc, Tatjana

AU - Logar, Mateja

AU - Mueller-Premru, Manica

AU - Commerford, Patrick

AU - Commerford, Anita

AU - Deetlefs, Eduan

AU - Hansa, Cass

AU - Ntsekhe, Mpiko

AU - Almela, Manuel

AU - Armero, Yolanda

AU - Azqueta, Manuel

AU - Castañeda, Ximena

AU - Cervera, Carlos

AU - Falces, Carlos

AU - Garcia-de-la-Maria, Cristina

AU - Fita, Guillermina

AU - Gatell, Jose M.

AU - Heras, Magda

AU - Llopis, Jaime

AU - Marco, Francesc

AU - Mestres, Carlos A.

AU - Miro, Jose M.

AU - Moreno, Asuncion

AU - Ninot, Salvador

AU - Pare, Carlos

AU - Pericas, Juan M.

AU - Ramirez, Jose

AU - Rovira, Irene

AU - Sitges, Marta

AU - Anguera, Ignasi

AU - Font, Bernat

AU - Guma, Joan Raimon

AU - Almirante, Benito

AU - Fernandez-Hidalgo, Nuria

AU - Tornos, Pilar

AU - Alarcon, Aristides de

AU - Parra, Ricardo

AU - Alestig, Eric

AU - Johansson, Magnus

AU - Olaison, Lars

AU - Snygg-Martin, Ulrika

AU - Casey, Anna

AU - Elliott, Tom

AU - Lambert, Peter

AU - Watkin, Richard

AU - Eyton, Christina

AU - Klein, John L.

AU - Bradley, Suzanne

AU - Kauffman, Carol

AU - Bedimo, Roger

AU - Lerakis, Stamatios

AU - Cantey, Robert

AU - Steed, Lisa

AU - Wray, Dannah

AU - Stuart, A. Dickerman

AU - Bonilla, Hector

AU - DiPersio, Joseph

AU - Salstrom, Sara Jane

AU - Baddley, John

AU - Patel, Mukesh

AU - Levine, Donald

AU - for the International Collaboration on Endocarditis (ICE) Investigators

PY - 2016

Y1 - 2016

N2 - Background-Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Methods and Results-Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0%) in the ICE-PCS cohort and 342 of 1197 (28.6%) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions-Six-month mortality after IE is 25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.

AB - Background-Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE. Methods and Results-Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE-PLUS, 2008-2012, n=1197). The 6-month mortality was 971 of 4049 (24.0%) in the ICE-PCS cohort and 342 of 1197 (28.6%) in the ICE-PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left-sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6-month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62-0.89). A simplified risk model was developed by weight adjustment of these variables. Conclusions-Six-month mortality after IE is 25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.

KW - Infection

KW - Mortality

KW - Prognosis

KW - Surgery

KW - Valves

UR - http://www.scopus.com/inward/record.url?scp=84995655527&partnerID=8YFLogxK

U2 - 10.1161/JAHA.115.003016

DO - 10.1161/JAHA.115.003016

M3 - Article

VL - 5

JO - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

JF - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

SN - 2047-9980

IS - 4

M1 - e003016

ER -