Preoperative Risk Evaluation In Acute Infective Endocarditis With The Euroscore Model. Initial Results

Objectives. There is an important role for accurate risk prediction in cardiac surgery. Prediction models are useful in prediction-making and quality assurance. Patients with infective endocarditis have a particular high- risk of morbidity and mortality. The aim of the study was to assess the performance of the EuroScore model in infective endocarditis.Methods. The additive and logistic EuroScore models were applied to all patients undergoing surgery for infective endocarditis between January 1995 and June 2006. Observed and predicted mortalities were compared. Calibration was assessed with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was tested by determining the area under the receiver operating characteristic (ROC) curve.Results. 191 cases of infective endocarditis were operated during the study period. The observed mortality was 28.8%. The mean calculated additive EuroScore was 10.37 +/- 10. Mean predicted logistic EuroScore mortality was 27.1 +/- 20.3%. Calibration of both models was good (Hosmer-Lemeshow test p > 0.05). Area under ROC curve was 0.835 (additive model) and 0.842 (logistic model).Conclusions. Although this sample size may be small, both the additive and logistic EuroScore adequately predicted risk in infective endocarditis. Larger sample size is needed to confirm the initial data.