Prediction of surgical risk in patients with endocarditis: Comparison of logistic EuroSCORE, EuroSCORE II and APORTEI score

Objectives: APORTEI score is a new risk prediction model for patients with infective endocarditis. It has been recently validated on a Spanish multicentric national cohort of patients. The aim of the present study is to compare APORTEI performances with logistic EuroSCORE and EuroSCORE II by testing calibration and discrimination on a local sample population underwent cardiac surgery because of endocarditis. Methods: We tested three prediction scores on 111 patients underwent surgery from 2014 to 2020 at our Institution because of infective endocarditis. Area under the curves and Hosmer-Lemeshow test were used to analyze discrimination and calibration respectively of logistic EuroSCORE, EuroSCORE II and APORTEI score. Results: The overall observed one-month mortality rate was 21.6%. The observed-to-expected ratio was 1.27 for logistic EuroSCORE, 3.27 for EuroSCORE II and 0.94 for APORTEI. The area under the curve (AUC) value of APORTEI (0.88 +/- 0.05) was significantly higher than that one of logistic EuroSCORE (AUC 0.77 +/- 0.05; p 0.0001) and of EuroSCORE II (AUC 0.74 +/- 0.05; p 0.0005). Hosmer-Lemeshow test showed better calibration performance of the APORTEI, (logistic EuroSCORE: p 0.19; EuroSCORE II: p 0.11; APORTEI: p 0.56). Conclusion: APORTEI risk score shows significantly higher performances in term of discrimination and calibration compared with both logistic EuroSCORE and EuroSCORE II. (C) 2020 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.