Risk prediction in infective endocarditis by modified MELD-XI score

Area of Science:

• Cardiology
• Hepatology
• Infectious Diseases

Background:

• The prognostic value of the Model for End-Stage Liver Disease excluding International Normalized Ratio (MELD-XI) score in infective endocarditis (IE) patients is not well-established.
• Accurate risk stratification is crucial for managing IE patients and predicting adverse outcomes.

Purpose of the Study:

• To evaluate the prognostic capability of the MELD-XI score for predicting adverse outcomes in IE patients.
• To develop and validate a modified MELD-XI score for enhanced prediction of mortality and major adverse clinical events in IE.

Main Methods:

• A cohort of 858 IE patients was analyzed.
• Patients were stratified based on MELD-XI score (≤10 vs. >10).
• Multivariate analysis identified independent risk factors, and a modified MELD-XI score was developed by incorporating NYHA class, C-reactive protein levels, and treatment strategy.

Main Results:

• Higher MELD-XI scores were significantly associated with increased in-hospital mortality and major adverse clinical events.
• The MELD-XI score independently predicted in-hospital death (OR=1.06).
• The modified MELD-XI score demonstrated superior predictive power (AUC 0.823 vs. 0.701) and was independently associated with long-term mortality (HR=1.08).

Conclusions:

• The MELD-XI score serves as a valuable tool for risk assessment in IE patients.
• The modified MELD-XI score provides a simple yet more effective approach for predicting poor prognosis in IE, including long-term mortality.