%0 Journal Article
%A Fernandez-Hidalgo, N
%A Ferreria-Gonzalez, I
%A Marsal, J R
%A Ribera, A
%A Aznar, M L
%A de Alarcon, A
%A Garcia-Cabrera, Emilio
%A Galvez-Acebal, J
%A Sanchez-Espin, G
%A Reguera-Iglesias, J M
%A De La Torre-Lima, J
%A Lomas, J M
%A Hidalgo-Tenorio, C
%A Vallejo, N
%A Miranda, B
%A Santos-Ortega, A
%A Castro, M A
%A Tornos, P
%A Garcia-Dorado, D
%A Almirante, B
%T A pragmatic approach for mortality prediction after surgery in infective endocarditis: optimizing and refining EuroSCORE.
%D 2018
%U http://hdl.handle.net/10668/12087
%X To simplify and optimize the ability of EuroSCORE I and II to predict early mortality after surgery for infective endocarditis (IE). Multicentre retrospective study (n = 775). Simplified scores, eliminating irrelevant variables, and new specific scores, adding specific IE variables, were created. The performance of the original, recalibrated and specific EuroSCOREs was assessed by Brier score, C-statistic and calibration plot in bootstrap samples. The Net Reclassification Index was quantified. Recalibrated scores including age, previous cardiac surgery, critical preoperative state, New York Heart Association >I, and emergent surgery (EuroSCORE I and II); renal failure and pulmonary hypertension (EuroSCORE I); and urgent surgery (EuroSCORE II) performed better than the original EuroSCOREs (Brier original and recalibrated: EuroSCORE I: 0.1770 and 0.1667; EuroSCORE II: 0.2307 and 0.1680). Performance improved with the addition of fistula, staphylococci and mitral location (EuroSCORE I and II) (Brier specific: EuroSCORE I 0.1587, EuroSCORE II 0.1592). Discrimination improved in specific models (C-statistic original, recalibrated and specific: EuroSCORE I: 0.7340, 0.7471 and 0.7728; EuroSCORE II: 0.7442, 0.7423 and 0.7700). Calibration improved in both EuroSCORE I models (intercept 0.295, slope 0.829 (original); intercept -0.094, slope 0.888 (recalibrated); intercept -0.059, slope 0.925 (specific)) but only in specific EuroSCORE II model (intercept 2.554, slope 1.114 (original); intercept -0.260, slope 0.703 (recalibrated); intercept -0.053, slope 0.930 (specific)). Net Reclassification Index was 5.1% and 20.3% for the specific EuroSCORE I and II. The use of simplified EuroSCORE I and EuroSCORE II models in IE with the addition of specific variables may lead to simpler and more accurate models.
%K EuroSCORE
%K Infective endocarditis
%K Mortality
%K Prognosis
%K Surgery
%~