Applicability and prognostic effect of Sequential Organ Failure Assessment score in adults hospitalized for infective endocarditis

【摘要】 Background Early identification of patients at risk for adverse outcomes is imperative to improve the prognosis of infective endocarditis(IE). Sequential Organ Failure Assessment(SOFA) score has been reported as an effective assessment tool for predicting the adverse outcomes of infectious diseases, but its applicability and predictive value in IE patients was still poorly known. Methods From 2009 to 2020, a total of 1354 patients diagnosed with definite IE according to the modified Duke criteria were included. SOFA score was calculated by the laboratory and clinical parameters within 24 hours of diagnosis. Discrimination and calibration of SOFA for inhospital mortality were analyzed. Results Patients were divided into two groups according to the optimal cutoff value of SOFA score =2 in the present cohort, which were determined by the receiver operating characteristic(ROC) analysis: High SOFA(≥2, n=496) group and low SOFA group(<2, n=858). SOFA score showed good discrimination and calibration for in-hospital mortality [area under the curve(AUC): 0.750, P<0.001; HosmerLemeshow P=0.210]. ROC curve showed that SOFA ≥2 had a sensitivity of 73.2% and specificity of 66.2% for predicting in-hospital death. Kaplan-Meier analysis showed that SOFA score ≥2 was associated with higher 6-month mortality(Log-rank: 96.3, P<0.001). Conclusions SOFA score is a practical risk assessment tool for patients admitted to hospital for IE and SOFA scores ≥2 is independently associated with in-hospital mortality. [S Chin J Cardiol 2021;22(4):231-238]更多还原

【Abstract】 Background Early identification of patients at risk for adverse outcomes is imperative to improve the prognosis of infective endocarditis(IE). Sequential Organ Failure Assessment(SOFA) score has been reported as an effective assessment tool for predicting the adverse outcomes of infectious diseases, but its applicability and predictive value in IE patients was still poorly known. Methods From 2009 to 2020, a total of 1354 patients diagnosed with definite IE according to the modified Duke criteria were included. SOFA score was calculated by the laboratory and clinical parameters within 24 hours of diagnosis. Discrimination and calibration of SOFA for inhospital mortality were analyzed. Results Patients were divided into two groups according to the optimal cutoff value of SOFA score =2 in the present cohort, which were determined by the receiver operating characteristic(ROC) analysis: High SOFA(≥2, n=496) group and low SOFA group(<2, n=858). SOFA score showed good discrimination and calibration for in-hospital mortality [area under the curve(AUC): 0.750, P<0.001; HosmerLemeshow P=0.210]. ROC curve showed that SOFA ≥2 had a sensitivity of 73.2% and specificity of 66.2% for predicting in-hospital death. Kaplan-Meier analysis showed that SOFA score ≥2 was associated with higher 6-month mortality(Log-rank: 96.3, P<0.001). Conclusions SOFA score is a practical risk assessment tool for patients admitted to hospital for IE and SOFA scores ≥2 is independently associated with in-hospital mortality. [S Chin J Cardiol 2021;22(4):231-238]更多还原