In:
Clinical Infectious Diseases, Oxford University Press (OUP), ( 2024-02-08)
Abstract:
The 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) Criteria for IE were introduced to improve classification of infective endocarditis (IE) for research and clinical purposes. External validation studies are required. Methods We studied consecutive patients with suspected IE referred to the IE Team of Amsterdam University Medical Center (October 2016-March 2021). An international expert panel independently reviewed case summaries, and assigned a final diagnosis of “IE” or “Not IE” , which served as the reference standard, to which the “Definite” Duke-ISCVID classifications were compared. We also evaluated accuracy when excluding cardiac surgery and pathology data (“Clinical Criteria”). Lastly, we compared the 2023 Duke-ISCVID to the 2000 Modified Duke Criteria and the 2015 and 2023 European Society of Cardiology (ESC) Criteria. Results 595 consecutive patients with suspected IE were included: 399 (67%) were adjudicated as IE; 111 (19%) had prosthetic valve IE and 48 (8%) had cardiac implantable electronic device IE. The 2023 Duke-ISCVID Criteria were more sensitive than either the Modified Duke or 2015 ESC Criteria (84.2% vs 74.9% and 80% respectively, p & lt; 0.001) without significant loss of specificity. The 2023 Duke-ISCVID Criteria were similarly sensitive but more specific than the 2023 ESC Criteria (94% vs 82%, p & lt;0.001). The same pattern was seen for the Clinical Criteria (excluding surgery/pathology results). New modifications in the 2023 Duke-ISCVID Criteria related to ‘Major Microbiological’ and ‘Imaging’ criteria were most impactful. Conclusion The 2023 Duke-ISCVID Criteria represent a significant advance in the diagnostic classification of patients with suspected IE.
Type of Medium:
Online Resource
ISSN:
1058-4838
,
1537-6591
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2024
detail.hit.zdb_id:
2002229-3
