The Infectious Endocarditis Mortality Risk Score can be used in patients with confirmed IE to assess mortality risk.

Addition of assigned points.

Host Factors
Age
	≤45	0
	46-60	+2
	61-70	+3
	>70	+4
History of Dialysis	No	0
	Yes	+3
IE Factors
Nosocomial IE	No	0
	Yes	+2
Prosthetic IE	No	0
	Yes	+1
Symptoms >1 month before admission	No	0
	Yes	-1
Staphylococcus aureus	No	0
	Yes	+1
Viridans group streptococci	No	0
	Yes	-2
Aortic vegetation	No	0
	Yes	+1
Mitral vegetation	No	0
	Yes	+1
IE Complications
NYHA class 3 or 4 heart failure	No	0
	Yes	+3
Stroke	No	0
	Yes	+2
Paravalvular complication	No	0
	Yes	+2
Persistent bacteremia	No	0
	Yes	+2
Surgical treatment	No	0
	Yes	-2

Probability of 6‐month mortality = 2.416*score+0.109*score²−4.849

A simplified risk score ≥8 had sensitivity 86.7% and specificity 50.8% for predicting overall 6‐month mortality (negative predictive value of 86% and positive predictive value of 39%).

The derivation cohort contained 4049 patients, and the validation cohort included 1197 subjects. This study was performed in referral centres (likely tertiary and quaternary academic centres) with experience with endocarditis and cardiac surgery.

Infective endocarditis (IE) has an overall 6-month mortality of approximately 25% in all-comers. Older age and history of dialysis appear to be the highest risk patient factors; IE complications also suggest a high mortality as well. Surgery is associated with a lower mortality rate but is infrequent in the high-risk cohort of patients. Mortality ranges from 10% in the lowest risk quintile to 53% in the highest-risk quintile. Surgery in this study was associated with lower mortality, but the highest risk patients were less likely to receive surgery (probably because they were high-risk surgical patients as well).

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Literature

1. Lawrence P. Park, Vivian H. Chu, Gail Peterson, Athanasios Skoutelis, Tatjana Lejko‐Zupa, Emilio Bouza, Pierre Tattevin, Gilbert Habib, Ren Tan, Javier Gonzalez, Javier Altclas, Jameela Edathodu, Claudio Querido Fortes, Rinaldo Focaccia Siciliano, Orathai Pachirat, Souha Kanj, Andrew Wang, and the International Collaboration on Endocarditis (ICE) Investigators. Validated Risk Score for Predicting 6‐Month Mortality in Infective Endocarditis. Journal of the American Heart Association.2016.Vol. 5, No. 4. 2016;5:e003016 https://doi.org/10.1161/JAHA.115.003016

See also:

Infective endocarditis. Diagnostic criteria for infective endocarditis