Heartbeat: Surgical risk scores in infective endocarditis

Infective endocarditis (IE) remains a highly mortal disease, with an in-hospital mortality of 15%–30%, despite current imaging and microbiological diagnosis and appropriate antibiotic therapy. One of the challenges in improving outcomes in patients with IE is risk stratification and optimal timing of surgical intervention. In this issue of Heart, Olmos and colleagues1 retrospectively analysed outcomes in 671 patients who underwent cardiac surgery for left-sided IE to develop and validate a risk score for prediction of perioperative mortality. This Risk-Endocarditis (RISK-E) score is based on both IE-specific factors, such as microorganism, prosthetic infection, paravalvular involvement and sepsis, and surgical factors, such as age, haemodynamics, thrombocytopenia and renal failure (table 1 and figure 1).

Figure 1

Predicted risk of postoperative mortality associated with individual Risk-Endocarditis (RISK-E) scores, according to the presence and scoring of each risk factor.