Acta cardiologica · 2025
Predicting in-hospital mortality in infective endocarditis: insights from the Naples prognostic score.
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Altunova Mehmet, Evsen Ali, Zencirkiran Agus Hicaz, Sevinc Samet, Ozturk Serpil, Melikoglu Erhan, Babur Guler Gamze
Аннотация
BACKGROUND: Infective Endocarditis (IE) is a severe and potentially life-threatening infection of the heart valves, necessitating a comprehensive understanding of factors influencing patient outcomes.
OBJECTIVE: The study aims to investigate the relationship between NPS and in-hospital mortality in patients diagnosed with Infective Endocarditis (IE).
METHODS: A total of 153 IE patients were included in the study, with 32 (20,9%) experiencing in-hospital mortality. Patients were categorised into survivors and non-survivors, and detailed clinical and demographic characteristics were recorded. The final endpoint of the study was determined as in-hospital mortality. Regression analyses were conducted to identify the independent variables, and Kaplan-Meier estimates were created to determine survival outcomes, using a significance level of p < 0.05 for all statistical analyses.
RESULTS: The non-survivor group exhibited a significantly higher NPS compared to the survivor group (28 (87.5) vs. 56 (46.3); p < 0.001). ROC curve analysis, utilising NPS, the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), albumin, and total cholesterol values, identified NPS as the most robust parameter, with an area under the curve of 0.704 (95% CI: 0.612-0.797; p < 0.001). Multivariate regression analysis revealed Septic shock (p = 0.001), NPS (p = 0.004), and Age (p = 0.012) as independent determinants of in-hospital mortality in IE patients.
CONCLUSIONS: This study demonstrated a strong correlation between NPS and mortality in IE. This novel score, as it reflects both the level of inflammation and nutrition, can be used to predict the prognosis in IE.
OBJECTIVE: The study aims to investigate the relationship between NPS and in-hospital mortality in patients diagnosed with Infective Endocarditis (IE).
METHODS: A total of 153 IE patients were included in the study, with 32 (20,9%) experiencing in-hospital mortality. Patients were categorised into survivors and non-survivors, and detailed clinical and demographic characteristics were recorded. The final endpoint of the study was determined as in-hospital mortality. Regression analyses were conducted to identify the independent variables, and Kaplan-Meier estimates were created to determine survival outcomes, using a significance level of p < 0.05 for all statistical analyses.
RESULTS: The non-survivor group exhibited a significantly higher NPS compared to the survivor group (28 (87.5) vs. 56 (46.3); p < 0.001). ROC curve analysis, utilising NPS, the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), albumin, and total cholesterol values, identified NPS as the most robust parameter, with an area under the curve of 0.704 (95% CI: 0.612-0.797; p < 0.001). Multivariate regression analysis revealed Septic shock (p = 0.001), NPS (p = 0.004), and Age (p = 0.012) as independent determinants of in-hospital mortality in IE patients.
CONCLUSIONS: This study demonstrated a strong correlation between NPS and mortality in IE. This novel score, as it reflects both the level of inflammation and nutrition, can be used to predict the prognosis in IE.