Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx
Background: Infective endocarditis is a life-threatening disease with diverse clinical presentations, making diagnosis challenging and requiring a range of complementary tests. The level of suspicion, based on clinical judgment, guides decisions regarding the initiation of empirical treatment and th...
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2024-11-01
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| author | Milena Ribeiro Paixão Bruno Adler Maccagnan Pinheiro Besen Lucas Zoboli Pocebon Marilia Francesconi Felicio Remo Holanda de Mendonça Furtado Pedro Gabriel Melo de Barros e Silva Danielle Menosi Gualandro Marcio Sommer Bittencourt Tânia Mara Varejão Strabelli Roney Orismar Sampaio Flávio Tarasoutchi Rinaldo Focaccia Siciliano |
| author_facet | Milena Ribeiro Paixão Bruno Adler Maccagnan Pinheiro Besen Lucas Zoboli Pocebon Marilia Francesconi Felicio Remo Holanda de Mendonça Furtado Pedro Gabriel Melo de Barros e Silva Danielle Menosi Gualandro Marcio Sommer Bittencourt Tânia Mara Varejão Strabelli Roney Orismar Sampaio Flávio Tarasoutchi Rinaldo Focaccia Siciliano |
| author_sort | Milena Ribeiro Paixão |
| collection | DOAJ |
| description | Background: Infective endocarditis is a life-threatening disease with diverse clinical presentations, making diagnosis challenging and requiring a range of complementary tests. The level of suspicion, based on clinical judgment, guides decisions regarding the initiation of empirical treatment and the selection of appropriate diagnostic tools. This study aimed to develop and validate the EndoPredict-Dx score for early prediction of infective endocarditis diagnosis. Methods: Patients admitted to a specialized cardiovascular hospital emergency department with suspected infective endocarditis between January 2011 and January 2020 were included. The primary outcome was left-sided infective endocarditis according to the Duke criteria. Logistic regression was used to derive the scoring system, with internal validation performed through bootstrapping. Candidate variables were obtained from the admission medical history, physical examination, and laboratory parameters. Results: Of the 805 individuals with suspected infective endocarditis (median age 56 years (40–73); 58.6% men), 530 confirmed the diagnosis based on the Duke criteria. The EndoPredict-Dx assigned points for male sex, previous endocarditis, petechiae, heart murmur, suspected embolism, symptoms lasting 14 or more days at the time of admission, hemoglobin level ≤ 12 g/dL, leukocyte level ≥ 10 × 10<sup>9</sup>/L, C-reactive protein level ≥ 20 mg/L, and urine red blood cells ≥ 20,000 cells/mL. Patients were divided into three risk groups. The AUROC was 0.78 (95% CI 0.75–0.81) for the derivation cohort and 0.77 for the internal validation. Conclusions: The EndoPredict-Dx score accurately predicted the likelihood of infective endocarditis using clinical and laboratory data collected at admission. |
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| institution | OA Journals |
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| publishDate | 2024-11-01 |
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| spelling | doaj-art-f71a9c9fb8f3407cbcfd6be2e6bb04a12025-08-20T02:28:04ZengMDPI AGDiagnostics2075-44182024-11-011422254710.3390/diagnostics14222547Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-DxMilena Ribeiro Paixão0Bruno Adler Maccagnan Pinheiro Besen1Lucas Zoboli Pocebon2Marilia Francesconi Felicio3Remo Holanda de Mendonça Furtado4Pedro Gabriel Melo de Barros e Silva5Danielle Menosi Gualandro6Marcio Sommer Bittencourt7Tânia Mara Varejão Strabelli8Roney Orismar Sampaio9Flávio Tarasoutchi10Rinaldo Focaccia Siciliano11Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilLIM-51, Departamento de Clínica Médica, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilBrazilian Clinical Research Institute, Sao Paulo 01404-000, SP, BrazilCardiology Department, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, SwitzerlandDepartment of Internal Medicine and Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USAInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, BrazilBackground: Infective endocarditis is a life-threatening disease with diverse clinical presentations, making diagnosis challenging and requiring a range of complementary tests. The level of suspicion, based on clinical judgment, guides decisions regarding the initiation of empirical treatment and the selection of appropriate diagnostic tools. This study aimed to develop and validate the EndoPredict-Dx score for early prediction of infective endocarditis diagnosis. Methods: Patients admitted to a specialized cardiovascular hospital emergency department with suspected infective endocarditis between January 2011 and January 2020 were included. The primary outcome was left-sided infective endocarditis according to the Duke criteria. Logistic regression was used to derive the scoring system, with internal validation performed through bootstrapping. Candidate variables were obtained from the admission medical history, physical examination, and laboratory parameters. Results: Of the 805 individuals with suspected infective endocarditis (median age 56 years (40–73); 58.6% men), 530 confirmed the diagnosis based on the Duke criteria. The EndoPredict-Dx assigned points for male sex, previous endocarditis, petechiae, heart murmur, suspected embolism, symptoms lasting 14 or more days at the time of admission, hemoglobin level ≤ 12 g/dL, leukocyte level ≥ 10 × 10<sup>9</sup>/L, C-reactive protein level ≥ 20 mg/L, and urine red blood cells ≥ 20,000 cells/mL. Patients were divided into three risk groups. The AUROC was 0.78 (95% CI 0.75–0.81) for the derivation cohort and 0.77 for the internal validation. Conclusions: The EndoPredict-Dx score accurately predicted the likelihood of infective endocarditis using clinical and laboratory data collected at admission.https://www.mdpi.com/2075-4418/14/22/2547infective endocarditisheart valve diseasedecision makingresource-limited settings |
| spellingShingle | Milena Ribeiro Paixão Bruno Adler Maccagnan Pinheiro Besen Lucas Zoboli Pocebon Marilia Francesconi Felicio Remo Holanda de Mendonça Furtado Pedro Gabriel Melo de Barros e Silva Danielle Menosi Gualandro Marcio Sommer Bittencourt Tânia Mara Varejão Strabelli Roney Orismar Sampaio Flávio Tarasoutchi Rinaldo Focaccia Siciliano Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx Diagnostics infective endocarditis heart valve disease decision making resource-limited settings |
| title | Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx |
| title_full | Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx |
| title_fullStr | Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx |
| title_full_unstemmed | Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx |
| title_short | Early Diagnostic Prediction of Infective Endocarditis: Development and Validation of EndoPredict-Dx |
| title_sort | early diagnostic prediction of infective endocarditis development and validation of endopredict dx |
| topic | infective endocarditis heart valve disease decision making resource-limited settings |
| url | https://www.mdpi.com/2075-4418/14/22/2547 |
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