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.

中文翻译：

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心内膜炎患者手术风险的预测：logistic EuroSCORE、EuroSCORE II 和 APORTEI 评分的比较

目标

APORTEI 评分是一种新的感染性心内膜炎患者风险预测模型。它最近已在西班牙多中心国家患者队列中得到验证。本研究的目的是通过对因心内膜炎而接受心脏手术的当地样本人群进行校准和歧视测试，比较 APORTEI 的表现与后勤 EuroSCORE 和 EuroSCORE II。

方法

我们对 2014 年至 2020 年在我们机构因感染性心内膜炎而接受手术的 111 名患者测试了三个预测评分。曲线下面积和Hosmer-Lemeshow检验分别用于分析logistic EuroSCORE、EuroSCORE II和APORTEI评分的区分和校准。

结果

总体观察到的 1 个月死亡率为 21.6%。后勤 EuroSCORE 的观察与预期比率为 1.27，EuroSCORE II 为 3.27，APORTEI 为 0.94。APORTEI (0.88  ±  0.05)的曲线下面积 (AUC) 值显着高于 Logistic EuroSCORE (AUC 0.77  ±  0.05; p = 0.0001) 和 EuroSCORE II (AUC 0.74  ±  0.05; p = 0.0005) 之一。Hosmer-Lemeshow 测试显示 APORTEI 具有更好的校准性能（logistic EuroSCORE：p 0.19；EuroSCORE II：p 0.11；APORTEI：p 0.56）。

结论

与后勤 EuroSCORE 和 EuroSCORE II 相比，APORTEI 风险评分在辨别和校准方面表现出显着更高的表现。