A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. The EndoSCORE

Michele Di Mauro*, Guglielmo Mario Actis Dato, Fabio Barili, Sandro Gelsomino, Pasquale Santse, Alessandro Della Corte, Antonio Carrozza, Ester Della Ratta, Diego Cugola, Lorenzo Galletti, Roger Devotini, Riccardo Casabona, Francesco Santini, Antonio Salsano, Roberto Scrofani, Carlo Antona, Luca Botta, Claudio Russo, Samuel Mancuso, Mauro RinaldiCarlo De Vincentiis, Andrea Biondi, Cesare Beghi, Giangiuseppe Cappabianca, Vincenzo Tarzia, Gino Gerosa, Michele De Bonis, Alberto Pozzoli, Francesco Nicolini, Filippo Benassi, Francesco Rosato, Elena Grasso, Ugolino Livi, Sponga Sandro, Davide Pacini, Roberto Di Bartolomeo, Andrea DeMartino, Uberto Bortolotti, Francesco Onorati, Giuseppe Faggian, Roberto Lorusso, Enrico Vizzardi, Gabriele Di Giammarco, Daniele Marinelli, Emmanuel Villa, Giovanni Troise, Marco Piciche, Francesco Musumeci, Domenico Paparella, Vito Margari, Grp Res Outcome Cardiac Surg GIROC

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: The aim of this large retrospective study was to provide a logistic risk model along an additive score to predict early mortality after surgical treatment of patients with heart valve or prosthesis infective endocarditis (IE).

Methods: From 2000 to 2015, 2715 patients with native valve endocarditis (NVE) or prosthesis valve endocarditis (PVE) were operated on in 26 Italian Cardiac Surgery Centers. The relationship between early mortality and covariates was evaluated with logistic mixed effect models. Fixed effects are parameters associated with the entire population or with certain repeatable levels of experimental factors, while random effects are associated with individual experimental units (centers).

Results: Early mortality was 11.0% (298/2715); At mixed effect logistic regression the following variables were found associated with early mortality: age class, female gender, LVEF, preoperative shock, COPD, creatinine value above 2 mg/dl, presence of abscess, number of treated valve/prosthesis (with respect to one treated valve/prosthesis) and the isolation of Staphylococcus aureus, Fungus spp., Pseudomonas Aeruginosa and other micro-organisms, while Streptococcus spp., Enterococcus spp. and other Staphylococci did not affect early mortality, as well as no micro-organisms isolation. LVEF was found linearly associated with outcomes while non-linear association between mortality and age was tested and the best model was found with a categorization into four classes (AUC = 0.851).

Conclusions: The following study provides a logistic risk model to predict early mortality in patients with heart valve or prosthesis infective endocarditis undergoing surgical treatment, called "The EndoSCORE". (C) 2017 Published by Elsevier Ireland Ltd.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
JournalInternational Journal of Cardiology
Publication statusPublished - 15 Aug 2017


  • Infective endocarditis
  • Risk score
  • Valve surgery
  • RISK

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