Evaluation of the 2023 Duke-International Society of Cardiovascular Infectious Diseases Criteria in a Multicenter...

Area of Science:

• Cardiology
• Infectious Diseases
• Diagnostic Criteria Evaluation

Background:

• The Duke criteria are standard for diagnosing infective endocarditis (IE).
• Several modifications to the Duke criteria have been proposed since their initial publication.
• Evaluating updated diagnostic criteria is crucial for accurate IE diagnosis.

Purpose of the Study:

• To compare the diagnostic performance of the 2023 Duke-ISCVID criteria against earlier versions (Duke-Li 2000 and Duke-ESC 2015).
• To assess the sensitivity and specificity of the latest infective endocarditis diagnostic guidelines.

Main Methods:

• A retrospective study involving 2132 patients with suspected IE across two university hospitals (2014-2022).
• IE cases were confirmed by an Endocarditis Team.
• Sensitivity and specificity of Duke criteria versions were calculated using pathological, surgical, and microbiological data.

Main Results:

• The Duke-ISCVID 2023 criteria demonstrated higher sensitivity (84%) compared to Duke-Li 2000 (70%) and Duke-ESC 2015 (70%).
• Specificity decreased with the Duke-ISCVID 2023 criteria (60%) compared to previous versions (74%).
• Out of 2132 suspected IE episodes, 1101 (52%) were confirmed IE cases.

Conclusions:

• The Duke-ISCVID 2023 criteria enhance sensitivity for diagnosing infective endocarditis.
• Further studies are required to optimize the criteria for improved sensitivity without compromising specificity.
• Refining IE diagnostic tools is essential for better patient outcomes.