Diagnostic accuracy of the Embolic Risk French Calculator for symptomatic embolism with infective endocarditis among Japanese population

Takahashi, Yusuke; Izumi, Chisato; Miyake, Makoto; Imanaka, Miyako; Kuroda, Maiko; Nishimura, Shunsuke; Yoshikawa, Yusuke; Amano, Masashi; Imamura, Sari; Onishi, Nobuyuki; Tamaki, Yodo; Enomoto, Soichiro; Tamura, Toshihiro; Kondo, Hirokazu; Kaitani, Kazuaki; Yamanaka, Kazuhiro; Nakagawa, Yoshihisa

doi:10.1016/j.jjcc.2017.04.003

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…All studies (except for one) counted systemic emboli as EEs; twelve studies also included pulmonary emboli [3,5,6,21,30,32,36,44,46,48,53,57], two studies included cutaneous emboli [6,29] and four studies included silent emboli [31,43,49,60]. Twelve studies included only new EEs occurring after admission or antibiotic therapy initiation [3,11,12,21,24,32,37,39,41,42,44,56], and two studies excluded EEs occurring after cardiac surgery [3,26]. One study did not define EEs [41].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among 11 studies including patients with EEs occurring at various times and reporting data, the overall proportion of patients with EEs whose embolism occurred before initiation of antibiotics was 53.3% (95% CI 38.0%e68.1%; see Supplementary material, Fig. S2) [3,6,8,11,13,26,28,30,43,44,56]. Of 34 studies pooled in meta-analyses of echocardiographic characteristics, six used transthoracic echocardiography [24,27,30,36,58,59], six used trans-oesophageal echocardiography [6,8,21,26,34,52], 16 used both [3,5,11,22,23,31e33, 37,44,46,48,49,53,56,57], and six did not specify the modality [13,28,45,47,51,55].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

Yang

Tan

Daneman

et al. 2019

Clinical Microbiology and Infection

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

Yang

Tan

Daneman

et al. 2019

Clinical Microbiology and Infection

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“…They found that a probability on the 28th hospital day >7% was closely associated with the in-hospital embolic risk. In contrast, Takahashi et al (12) defined a probability on the 14th hospital day >8% as indicative of a high risk and demonstrated that the incidence of new embolic events during a 12-week observation period was significantly higher in the high-risk group than in the low-risk group. Thus, the probability on the 14th hospital day may predict longer-term outcomes.…”

Section: Discussionmentioning

confidence: 98%

“…Nevertheless, we did not assess the prothrombic activity in the present study. Fourth, we used a probability >8% as the cut-off value for the high-risk group, according to a previous report (12). Alternatively, we could have independently determined the optimal cut-off value using a receiver operating characteristic curve analysis.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Acute-phase Complications in Patients with Infectious Endocarditis

et al. 2019

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Objective Embolic events are frequent and life-threatening complications of infective endocarditis (IE). Recently, an embolic risk assessment at admission, based on the Embolic Risk (ER) French Calculator, was designed to predict the development of symptomatic emboli associated with IE. This study aimed to validate the ER French Calculator for the prediction of in-hospital events, including embolic events. Methods We retrospectively analyzed the clinical features of 52 consecutive patients with left-sided IE to identify possible predictors of in-hospital events within 30 days of admission. Results New embolic events were seen in 15 patients (29%), cardiac surgery was performed in 22 patients (42%), and 1 patient (2%) died within 30 days of admission. A composite endpoint of embolic complications, cardiac surgery, or death was observed in 28 patients (54%). The cumulative incidence of new embolic events was significantly higher in the high-risk group identified by the ER French Calculator than in the low-risk group (log-rank test; p=0.0004). The incidence of the composite endpoint was higher in the high-risk group than in the low-risk group (log-rank test; p<0.0001). A multivariate Cox proportional hazards model indicated that the high-risk designation on the ER French Calculator predicted embolic events (p=0.0410) and composite events (p=0.0371) independently of other candidate predictors. Conclusion The ER French Calculator may be a useful tool for predicting new in-hospital embolic events and other unfavorable in-hospital events in patients with IE.

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Risk of embolic events before and after antibiotic treatment initiation among patients with left-side infective endocarditis

Papadimitriou-Olivgeris

Guéry

Ianculescu

et al. 2023

Infection

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Purpose Embolic events (EEs) are a common complication of left-side infective endocarditis (IE). The aim of the present study was to identify risk factors for the occurrence of EEs before or after antibiotic treatment instauration among patients with definite or possible IE. Methods This retro-prospective study was conducted at the Lausanne University Hospital, Lausanne, Switzerland, from January 2014 to June 2022. EEs and IE were defined according to modified Duke criteria. Results A total of 441 left-side IE episodes were included (334: 76% were definite and 107; 24% possible IE). EE were diagnosed in 260 (59%) episodes; in 190 (43%) before antibiotic treatment initiation and 148 (34%) after. Central nervous system (184; 42%) was the most common site of EE. Multivariable analysis identified S. aureus (P 0.022), immunological phenomena (P < 0.001), sepsis (P 0.027), vegetation size ≥ 10 mm (P 0.003) and intracardiac abscess (P 0.022) as predictors of EEs before antibiotic treatment initiation. For EEs after antibiotic treatment initiation, multivariable analysis revealed vegetation size ≥ 10 mm (P < 0.001), intracardiac abscess (P 0.035) and prior EE (P 0.042), as independent predictors of EEs, while valve surgery (P < 0.001) was associated with lower risk for EEs. Conclusions We reported a high percentage of EEs among patients with left-side IE; vegetation size, intracardiac abscess, S. aureus and sepsis were independently associated with the occurrence of EEs. In addition to antibiotic treatment, early surgery led to further decrease in EEs incidence.

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Diagnostic accuracy of the Embolic Risk French Calculator for symptomatic embolism with infective endocarditis among Japanese population

Abstract: The ER-Calculator is a useful predictor of new SE. Predictive ability is more remarkable for critical embolic events.

Cited by 7 publications

References 25 publications

Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

Prediction of Acute-phase Complications in Patients with Infectious Endocarditis

Risk of embolic events before and after antibiotic treatment initiation among patients with left-side infective endocarditis

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