Key result
Elevated maximum postoperative lactate levels and higher ACEF II Scores were robust predictors of 1-year mortality (AUC 0.759 and 0.729, respectively) in patients undergoing valve surgery for infective endocarditis.
Why the study?
To evaluate the prognostic value of routine laboratory parameters, including lactate, troponin-T, and CK-MB, and two mortality scores (EuroSCORE II and ACEF II Score) for predicting mortality in surgically treated endocarditis.
Do postoperative lactate levels and the ACEF II Score predict short- and long-term mortality in patients undergoing valve surgery for infective endocarditis?
Cohort (n=130)
No
Do postoperative lactate levels and the ACEF II Score predict short- and long-term mortality in patients undergoing valve surgery for infective endocarditis?
Effect estimate: AUC 0.759
p-value: p=<0.001
Postoperative lactate levels and the ACEF II Score are robust predictors of short- and long-term mortality in patients undergoing cardiac surgery for infective endocarditis, outperforming the EuroSCORE II.
Postoperative lactate and ACEF II may aid risk stratification after endocarditis surgery; leaves open need for prospective validation before clinical adoption.
OBJECTIVES: This study aimed to assess the prognostic value of routinely collected laboratory parameters, specifically lactate, troponin-T, and CK-MB, in predicting mortality in patients with surgically treated endocarditis. Additionally, the study evaluated the effectiveness of two mortality scores, EuroSCORE II and ACEF II Score, in this clinical context. METHODS: We retrospectively analyzed data from 130 patients diagnosed with endocarditis who underwent surgery at a single tertiary center over nine years. The study utilized preoperative mortality scores and laboratory parameters collected within the first 24 h post-surgery. Statistical analyses included AUROC curves, Kaplan-Meier survival analyses, and correlation analyses to determine predictive values and associations with patient outcomes. RESULTS: Among the 130 patients, 28 (21.5%) died within one year post-surgery. Elevated postoperative lactate levels were significantly associated with increased short- and long-term mortality, with AUROC values indicating strong predictive capability. The ACEF II Score also demonstrated significant predictive value for mortality at various time points, outperforming EuroSCORE II. Higher lactate levels and ACEF II Scores correlated with increased hazard ratios for mortality. Kaplan-Meier analyses revealed significant survival differences based on lactate and ACEF II Score thresholds. CONCLUSION: Postoperative lactate levels and the ACEF II Score are robust predictors of mortality in patients undergoing cardiac surgery for endocarditis. Integrating these parameters into clinical practice can enhance risk stratification and guide therapeutic decisions, improving patient outcomes through personalized care. Further studies are needed to validate these findings across diverse populations and explore additional biomarkers for refined predictive accuracy.
No takes yet. Share an insight, caveat, or question.
Dinges et al. (2024) conducted a cohort in Infective endocarditis (n=130). Elevated postoperative lactate and ACEF II Score vs. Lower lactate and ACEF II Score was evaluated on 1-year mortality prediction by postoperative lactate (AUC 0.759, p=<0.001). Elevated maximum postoperative lactate levels and higher ACEF II Scores were robust predictors of 1-year mortality (AUC 0.759 and 0.729, respectively) in patients undergoing valve surgery for infective endocarditis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: