@article{PAR00010934,
  title = {{P}rediction of symptomatic embolism in infective endocarditis},
  author = {{H}ubert, {S}. and {T}huny, {F}. and {R}esseguier, {N}. and {G}iorgi, {R}. and {T}ribouilloy, {C}. and {L}e {D}olley, {Y}. and {C}asalta, {J}. {P}. and {R}iberi, {A}. and {C}hevalier, {F}. and {R}usinaru, {D}. and {M}alaquin, {D}. and {R}emadi, {J}. {P}. and {B}en {A}mmar, {A}. and {A}vierinos, {J}. {F}. and {C}ollart, {F}. and {R}aoult, {D}idier and {H}abib, {G}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives {T}he aim of this study was to develop and validate a simple calculator to quantify the embolic risk ({ER}) at admission of patients with infective endocarditis. {B}ackground {E}arly valve surgery reduces the incidence of embolism in high-risk patients with endocarditis, but the quantification of {ER} remains challenging. {M}ethods {F}rom 1,022 consecutive patients presenting with definite diagnoses of infective endocarditis in a multicenter observational cohort study, 847 were randomized into derivation (n = 565) and validation (n = 282) samples. {C}linical, microbiological, and echocardiographic data were collected at admission. {T}he primary endpoint was symptomatic embolism that occurred during the 6-month period after the initiation of treatment. {T}he prediction model was developed and validated accounting for competing risks. {R}esults {T}he 6-month incidence of embolism was similar in the development and validation samples (8.5% in the 2 samples). {S}ix variables were associated with {ER} and were used to create the calculator: age, diabetes, atrial fibrillation, embolism before antibiotics, vegetation length, and {S}taphylococcus aureus infection. {T}here was an excellent correlation between the predicted and observed {ER} in both the development and validation samples. {T}he {C}-statistics for the development and validation samples were 0.72 and 0.65, respectively. {F}inally, a significantly higher cumulative incidence of embolic events was observed in patients with high predicted {ER} in both the development (p < 0.0001) and validation (p < 0.05) samples. {C}onclusions {T}he risk for embolism during infective endocarditis can be quantified at admission using a simple and accurate calculator. {I}t might be useful for facilitating therapeutic decisions.},
  keywords = {embolism ; endocarditis ; prognosis},
  booktitle = {},
  journal = {{J}ournal of the {A}merican {C}ollege of {C}ardiology},
  volume = {62},
  numero = {15},
  pages = {1384--1392},
  ISSN = {0735-1097},
  year = {2013},
  DOI = {10.1016/j.jacc.2013.07.029},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00010934},
}