Performance of Risk Scores in Predicting Infective Endocarditis in Patients with <i>Staphylococcus aureus</i> Bacteraemia in a Prospective Asian Cohort

Abstract

Background: Several risk scores have been derived to predict the risk of infective endocarditis (IE) amongst patients with Staphylococcus aureus bacteraemia (SAB), which helps to guide clinical management. Methods: We prospectively studied 634 patients admitted with SAB. The cohort was stratified into those with or without IE, and the PREDICT Day 1, Day 5 and VIRSTA scores were tabulated. Area under the receiver operating characteristic (AUC) curves were constructed to compare the performance of each score. Results: Of the 634 patients examined, 36 (5.7%) had IE. These patients were younger (51.6 ± 20.1 vs. 59.2 ± 18.0 years, p = 0.015), tended to have community acquisition of bacteraemia (41.7% vs. 17.9%, p p = 0.002). The VIRSTA score had the best performance in predicting IE (AUC 0.76, 95%CI 0.66–0.86) compared with PREDICT Day 1 and Day 5. A VIRSTA score of Conclusions: Overall, the risk scores performed well in our Asian cohort. If applied, 23.5% of the cohort with a VIRSTA ≥ 3 would require TEE, and a score of <3 had an excellent negative predictive value.

Keywords

• <i>Staphylococcus aureus</i> bacteraemia
• infective endocarditis
• risk score
• mortality