ToolsCalculators
Infective Endocarditis (IE) Mortality Risk Score
Estimates 6-month mortality in patients with definite infective endocarditis.
Infective Endocarditis (IE) Mortality Risk Score
Age
History of dialysis
Nosocomial infective endocarditis
Prosthetic valve infective endocarditis
Symptoms present >1 month before admission
Staphylococcus aureus infection
Viridans group streptococcal infection
Aortic valve vegetation
Mitral valve vegetation
NYHA class III or IV heart failure
Stroke
Paravalvular complication
Persistent bacteremia
Surgical treatment of infective endocarditis
Result0 points
Higher scores are associated with progressively higher 6-month mortality; overall mortality ranged from about 10% in the lowest-risk quintile to 53% in the highest-risk quintile of the derivation cohort.
- Validated high-risk cut point
- ≥8 points
When to use
- Estimating 6-month mortality risk in patients with definite infective endocarditis to inform prognosis discussions.
- Identifying patients who may benefit from early cardiac surgery or infectious disease/cardiac surgery co-management.
Formula
Points: age 46-60 +2 / 61-70 +3 / >70 +4 (≤45 = 0), dialysis +3, nosocomial infection +2, prosthetic valve IE +1, symptoms >1 month before admission −1, S. aureus +1, viridans streptococci −2, aortic vegetation +1, mitral vegetation +1, NYHA III/IV heart failure +3, stroke +2, paravalvular complication +2, persistent bacteremia +2, surgical treatment −2.
Pearls and pitfalls
- Derived and externally validated in the multinational ICE-PCS and ICE-PLUS prospective endocarditis registries.
- Older age and dialysis dependence were the strongest individual risk factors for death; surgical treatment and viridans streptococcal infection were associated with lower mortality.