The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Studied Variables
2.2. Definitions
2.3. Clinical Endpoint
2.4. Statistical Analysis
3. Results
3.1. Survival and Non-Survival Groups in Comparison
3.2. Comparison between Pre-Existing Valve Disease and No Pre-Existing Valve Disease
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Baseline Characteristic/ Variables | All Patients n = 517 (%) | Discharge n = 372 (%) | In-Hospital Death n = 145 (%) | OR | 95% CI | p Value |
---|---|---|---|---|---|---|
Age (median; years) | 57 (18–87) | 56 (18–87) | 58.7 (18–86) | - | - | - |
Male | 334 (64.6) | 243 (65.3) | 91 (62.7) | 0.894 | 0.600–1.332 | 0.584 |
Hypertension | 270 (52.2) | 181 (48.6) | 89 (61.3) | 1.677 | 1.134–2.480 | 0.009 |
Diabetes mellitus | 97 (18.7) | 57 (15.3) | 40 (27.5) | 2.105 | 1.328–3.337 | 0.001 |
Chronic kidney disease | 59 (11.4) | 36 (9.6) | 23 (15.8) | 1.759 | 1.002–3.088 | 0.049 |
Hemodialysis | 34 (6.5) | 21 (5.6) | 13 (8.9) | 1.646 | 0.868–1.453 | 0.109 |
Pre-existing valve disease 1 | 435 (84.1) | 315 (84.6) | 120 (82.7) | 0.868 | 0.801–3.382 | 0.536 |
Staphylococcus aureus | 49 (9.4) | 28 (7.5) | 21 (14.4) | 2.080 | 1.139–3.798 | 0.015 |
Streptococcus group | 186 (35.9) | 150 (40.3) | 36 (24.8) | 0.488 | 0.318–0.751 | 0.001 |
Enterococcus species | 50 (9.6) | 26 (6.9) | 24 (16.5) | 2.639 | 1.460–4.772 | 0.001 |
Culture positive | 409 (79.1) | 298 (80.1) | 111 (76.5) | 0.8107 | 0.511–1.285 | 0.372 |
NYHA III/IV | 206 (39.8) | 128 (34.4) | 78 (53.7) | 2.219 | 1.502–3.798 | <0.001 |
Embolism (n = 514) | 96 (18.6) | 60 (16.2) | 36 (24.8) | 1.700 | 1.065–2.714 | 0.025 |
Valve abscesses (n = 505) | 62 (12.2) | 40 (10.9) | 22 (15.6) | 1.497 | 0.854–2.624 | 0.158 |
Hemoglobin (g/dL) (n = 500) | 10.8 (4.5–23.8) | 11 (5.3–23.8) | 10.1 (4.5–16) | - | - | <0.001 |
Platelets (mg/L) (n = 498) | 193.000 (2.000–557.000) | 199.000 (2.000–550.000) | 173.000 (12.330–557.000) | - | - | 0.010 |
Leukocyte (mg/L) (n = 500) | 10.360 (550–42.000) | 9.960 (1.1000–35.000) | 12.040 (550–42.000) | - | - | <0.001 |
C-reactive protein (mg/L) (n = 495) | 89 (1.6–402) | 86.6 (1.96–389.2) | 141.5 (68.5–197) | - | - | 0.012 |
Creatinine (mg/dL) (n = 499) | 1.2 (0.45–15.4) | 1.1 (0.45–15.5) | 1.5 (0.53–12.34) | - | - | <0.001 |
Time of symptoms (n = 509) | 16 (0–370) | 17 (0–370) | 14 (0–366) | 0.264 |
Variables | All Patients n = 465 (%) | Discharge n = 372 (%) | In-Hospital Death n = 145 (%) | OR | 95% CI | p Value |
---|---|---|---|---|---|---|
qSOFA ≥ 2 | 45 (9.6) | 18(5.4) | 27(20.4) | 4.5 | 2.382–8.500 | <0.001 |
SOFA ≥ 2 | 164 (35.2) | 88(26.4) | 76(57.5) | 3.778 | 2.476–5.764 | <0.001 |
Variable | OR | 95% CI | p Value |
---|---|---|---|
NHYA III/IV | 2.37 | 1.497–3.751 | <0.001 |
Embolism at admission | 1.91 | 1.097–3.324 | 0.022 |
SOFA ≥ 2 | 3.26 | 2.076–5.137 | <0.001 |
Diabetes mellitus | 2.45 | 1.490–4.345 | 0.001 |
Hemoglobin | 0.860 | 0.773–0.956 | 0.005 |
Score | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95%CI) | LR + (95% CI) | ||
---|---|---|---|---|---|---|---|
qSOFA ≥ 2 | 20 (14–27) | 95 (92–97) | 60 (46–74) | 75 (71–79) | 3.78 (2.16–6.63) | ||
SOFA ≥ 2 | 58 (49–66) | 74 (69–78) | 46 (39–54) | 81 (77–86) | 2.18 (1.73–2.75) | ||
With pre-existing Valve disease AUC ROC (95% CI) | Without pre-existing valve disease AUC ROC (95% CI) | ||||||
qSOFA | 0.551 (0.485–0.617) | 0.718 (0.524–0.912) | |||||
SOFA | 0.627 (0.563–0.690) | 0.775 (0.594–0.956) |
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Almeida, B.L.d.; Strabelli, T.M.V.; Bittencourt, M.S.; Oliveira, V.F.d.; Gualandro, D.M.; Mansur, A.J.; Tarasouchi, F.; Pocebon, L.; Paixão, M.; Goldemberg, F.; et al. The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis. Trop. Med. Infect. Dis. 2024, 9, 23. https://doi.org/10.3390/tropicalmed9010023
Almeida BLd, Strabelli TMV, Bittencourt MS, Oliveira VFd, Gualandro DM, Mansur AJ, Tarasouchi F, Pocebon L, Paixão M, Goldemberg F, et al. The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis. Tropical Medicine and Infectious Disease. 2024; 9(1):23. https://doi.org/10.3390/tropicalmed9010023
Chicago/Turabian StyleAlmeida, Bianca Leal de, Tania Mara Varejao Strabelli, Marcio Sommer Bittencourt, Vítor Falcão de Oliveira, Danielle Menosi Gualandro, Alfredo Jose Mansur, Flavio Tarasouchi, Lucas Pocebon, Milena Paixão, Flora Goldemberg, and et al. 2024. "The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis" Tropical Medicine and Infectious Disease 9, no. 1: 23. https://doi.org/10.3390/tropicalmed9010023
APA StyleAlmeida, B. L. d., Strabelli, T. M. V., Bittencourt, M. S., Oliveira, V. F. d., Gualandro, D. M., Mansur, A. J., Tarasouchi, F., Pocebon, L., Paixão, M., Goldemberg, F., Salomão, R., & Siciliano, R. F. (2024). The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis. Tropical Medicine and Infectious Disease, 9(1), 23. https://doi.org/10.3390/tropicalmed9010023