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dc.contributor.authorPark, LP
dc.contributor.authorChu, VH
dc.contributor.authorPeterson, G
dc.contributor.authorSkoutelis, A
dc.contributor.authorLejko-Zupa, T
dc.contributor.authorBouza, E
dc.contributor.authorTattevin, P
dc.contributor.authorHabib, G
dc.contributor.authorTan, R
dc.contributor.authorGonzalez, J
dc.contributor.authorAltclas, J
dc.contributor.authorEdathodu, J
dc.contributor.authorFortes, CQ
dc.contributor.authorSiciliano, RF
dc.contributor.authorPachirat, O
dc.contributor.authorKanj, S
dc.contributor.authorWang, A
dc.contributor.authorInternational Collaboration on Endocarditis (ICE) Investigators
dc.date.accessioned2020-12-21T02:17:19Z
dc.date.available2020-12-21T02:17:19Z
dc.date.issued2016-04-18
dc.identifierpii: JAHA.115.003016
dc.identifier.citationPark, L. P., Chu, V. H., Peterson, G., Skoutelis, A., Lejko-Zupa, T., Bouza, E., Tattevin, P., Habib, G., Tan, R., Gonzalez, J., Altclas, J., Edathodu, J., Fortes, C. Q., Siciliano, R. F., Pachirat, O., Kanj, S., Wang, A. & International Collaboration on Endocarditis (ICE) Investigators (2016). Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis.. J Am Heart Assoc, 5 (4), pp.e003016-. https://doi.org/10.1161/JAHA.115.003016.
dc.identifier.issn2047-9980
dc.identifier.urihttp://hdl.handle.net/11343/256862
dc.description.abstractBACKGROUND: 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.
dc.languageeng
dc.publisherOvid Technologies (Wolters Kluwer Health)
dc.titleValidated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis.
dc.typeJournal Article
dc.identifier.doi10.1161/JAHA.115.003016
melbourne.affiliation.departmentMedical Education
melbourne.source.titleJournal of the American Heart Association
melbourne.source.volume5
melbourne.source.issue4
melbourne.source.pagese003016-
dc.rights.licenseCC BY-NC
melbourne.elementsid1233730
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859286
melbourne.contributor.authorAthan, Eugene
dc.identifier.eissn2047-9980
melbourne.accessrightsOpen Access


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