Fernandez-Hidalgo, NFerreria-Gonzalez, IMarsal, J RRibera, AAznar, M Lde Alarcon, AGarcia-Cabrera, EmilioGalvez-Acebal, JSanchez-Espin, GReguera-Iglesias, J MDe La Torre-Lima, JLomas, J MHidalgo-Tenorio, CVallejo, NMiranda, BSantos-Ortega, ACastro, M ATornos, PGarcia-Dorado, DAlmirante, B2023-01-252023-01-252018-03-03Fernández-Hidalgo N, Ferreria-González I, Marsal JR, Ribera A, Aznar ML, de Alarcón A, et al. A pragmatic approach for mortality prediction after surgery in infective endocarditis: optimizing and refining EuroSCORE. Clin Microbiol Infect. 2018 Oct;24(10):1102.e7-1102.e15http://hdl.handle.net/10668/12087To 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.enEuroSCOREInfective endocarditisMortalityPrognosisSurgeryCardiac Surgical ProceduresEndocarditisEndocarditis, BacterialFemaleHospital MortalityHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk Factorsresearch article29408350Restricted accessCirugía generalCalibraciónFístulaInsuficiencia renalEndocarditisSelección del sitio de tratamiento de residuosCirugía torácica10.1016/j.cmi.2018.01.0191469-0691http://www.clinicalmicrobiologyandinfection.com/article/S1198743X18300909/pdf