Performance of the SHARPEN Score and the Charlson Comorbidity Index for In-Hospital and Post-Discharge Mortality Prediction in Infective Endocarditis.

Autor:	Alves SG; Hospital de Clínicas de Porto Alegre, Porto Alegre (HCPA), RS - Brasil., Pivatto Júnior F; Hospital de Clínicas de Porto Alegre, Porto Alegre (HCPA), RS - Brasil.; Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, RS - Brasil., Filippini FB; Instituto de Cardiologia de Santa Catarina, São José, SC - Brasil., Dannenhauer GP; Instituto de Cardiologia de Santa Catarina, São José, SC - Brasil., Seroiska G; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS - Brasil., Bischoff HM; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS - Brasil., Birk LFS; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS - Brasil., Terra DH; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS - Brasil., Sganzerla D; Unimed Porto Alegre Cooperativa Médica, Porto Alegre, RS - Brasil., Miglioranza MH; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS - Brasil.; Unimed Porto Alegre Cooperativa Médica, Porto Alegre, RS - Brasil.; Instituto de Cardiologia do Rio Grande do Sul (ICFUC-RS) - Laboratório de Pesquisa e Inovação em Imagem Cardiovascular, Porto Alegre, RS - Brasil.; Hospital Mãe de Deus, Porto Alegre, RS - Brasil.
Jazyk:	Portuguese; English
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2024 Mar 04; Vol. 120 (12), pp. e20230441. Date of Electronic Publication: 2024 Mar 04 (Print Publication: 2024).
DOI:	10.36660/abc.20230441
Abstrakt:	Background: Central Illustration : Performance of the SHARPEN Score and the Charlson Comorbidity Index for In-Hospital and Post-Discharge Mortality Prediction in Infective Endocarditis. Background: SHARPEN was the first dedicated score for in-hospital mortality prediction in infective endocarditis (IE) regardless of cardiac surgery. Objectives: To analyze the ability of the SHARPEN score to predict in-hospital and post-discharge mortality and compare it with that of the Charlson comorbidity index (CCI). Methods: Retrospective cohort study including definite IE (Duke modified criteria) admissions from 2000 to 2016. The area under the ROC curve (AUC-ROC) was calculated to assess predictive ability. Kaplan-Meier curves and Cox regression was performed. P-value < 0.05 was considered statistically significant. Results: We studied 179 hospital admissions. In-hospital mortality was 22.3%; 68 (38.0%) had cardiac surgery. Median (interquartile range, IQR) SHARPEN and CCI scores were 9(7-11) and 3(2-6), respectively. SHARPEN had better in-hospital mortality prediction than CCI in non-operated patients (AUC-ROC 0.77 vs. 0.62, p = 0.003); there was no difference in overall (p = 0.26) and in operated patients (p = 0.41). SHARPEN > 10 at admission was associated with decreased in-hospital survival in the overall (HR 3.87; p < 0.001), in non-operated (HR 3.46; p = 0.006) and operated (HR 6.86; p < 0.001) patients. CCI > 3 at admission was associated with worse in-hospital survival in the overall (HR 3.0; p = 0.002), and in operated patients (HR 5.57; p = 0.005), but not in non-operated patients (HR 2.13; p = 0.119). Post-discharge survival was worse in patients with SHARPEN > 10 (HR 3.11; p < 0.001) and CCI > 3 (HR 2.63; p < 0.001) at admission; however, there was no difference in predictive ability between these groups. Conclusion: SHARPEN was superior to CCI in predicting in-hospital mortality in non-operated patients. There was no difference between the scores regarding post-discharge mortality.
Databáze:	MEDLINE
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