RiskE Score for Cardiac Surgery in Active Infective Endocarditis
RiskE Score Calculator
Age ≥65 years
Prosthetic Valve
Paravalvular Abscess
Urgent / Emergency Surgery
Septic Shock
Cardiogenic Shock
Acute Renal Failure
Active Endocarditis at Time of Surgery
RiskE Score:
0
Low Risk
Score 0: Low operative mortality risk. Favorable surgical prognosis.
Predicts perioperative mortality in patients with active left-sided endocarditis.
Why Use
Mortality in infective endocarditis is high (15-30%) and approximately half of all patients with active endocarditis will require surgery in the acute phase ( Habib 2015 ). A validated risk stratification score such as RiskE may help inform the decision to operate, which is multifactorial.
When to Use
Should not be used in isolated right-sided endocarditis, or after active infection has been treated and healed.
Formula
Addition of the selected points: Variable Points Age, years ≤51 0 52-63 9 64-72 13 ≥73 14 Prosthetic endocarditis No 0 Yes 6 Virulent microorganism* No 0 Yes 9 Septic shock No 0 Yes 7 Thrombocytopenia** No 0 Yes 7 Acute renal insufficiency No 0 Yes 5 Cardiogenic shock No 0 Yes 15 Periannular complications*** No 0 Yes 5 *Staphylococcus aureus or fungi. **<150,000 platelets/mm 3 . ***Abscess, pseudoaneurysm, fistula, or prosthetic dehiscence. From Olmos 2017 .
Advice
A multidisciplinary approach including input from cardiology, imaging, cardiothoracic surgery, and infectious diseases, which incorporates patient goals of care, is warranted in deciding whether to operate or not.
More Information
Interpretation: Refer to Table S3 in Olmos 2017 for the predicted in-hospital postop mortality at each RiskE score.