Compared Performance of the 2023 Duke-International Society for Cardiovascular Infectious Diseases, 2000 Modified Duke, and 2015 European Society of Cardiology Criteria for the Diagnosis of Infective Endocarditis in a French Multicenter Prospective Cohort

被引：11

作者：

Goehringer, Francois ^{[1
]}

Lalloue, Benoit ^{[2
]}

Selton-Suty, Christine ^{[3
]}

Alla, Francois ^{[4
,5
]}

Botelho-Nevers, Elisabeth ^{[6
,7
]}

Chirouze, Catherine ^{[8
,9
]}

Curlier, Elodie ^{[10
]}

El Hatimi, Safwane ^{[11
]}

Gagneux-Brunon, Amandine ^{[6
,7
]}

le Moing, Vincent ^{[12
,13
]}

Lim, Pascal ^{[14
]}

Piroth, Lionel ^{[15
,16
]}

Strady, Christophe ^{[17
]}

Tribouilloy, Christophe ^{[18
,19
]}

Virion, Jean-Marc ^{[2
]}

Agrinier, Nelly ^{[2
]}

Duval, Xavier ^{[20
,21
,22
,23
]}

Hoen, Bruno ^{[24
]}

机构：

[1] CHRU Nancy, Serv Malad Infect & Trop, Nancy, France

[2] Univ Lorraine, CHRU Nancy, INSERM, CIC,Epidemiol Clin, Nancy, France

[3] CHRU Nancy, CIC EC, Dept Med Cardiol, Nancy, France

[4] Univ Bordeaux, INSERM, U1219, BPH,I Prev PHARES,CIC 1401, Bordeaux, France

[5] CHU Bordeaux, Serv Prevent, F-33000 Bordeaux, France

[6] CHU St Etienne, Serv Malad Infect, St Etienne, France

[7] Univ Lyon, Univ Jean Monnet, CNRS, UMR530,Inserm,U1111,CIRI,Team GIMAP, St Etienne, France

[8] Univ Bourgogne Franche Comte, CNRS, Chronoenvironm UMR6249, Besancon, France

[9] CHU Jean Minjoz, Serv Malad Infect & Trop, Besancon, France

[10] CHU Guadeloupe, Serv Malad Infect, Pointe A Pitre, Guadeloupe, France

[11] Univ Paris Saclay, CHU Bicetre, Le Kremlin Bicetre, France

[12] CHU Montpellier, Serv Malad Infect & Trop, Montpellier, France

[13] Univ Montpellier, Montpellier, France

[14] Univ Paris Est Creteil, Hop Univ Henri Mondor, AP HP, Fac Sante, Creteil, France

[15] CHU Dijon, Serv Malad Infect, Dijon, France

[16] Univ Bourgogne, INSERM, CIC 1432, CHU Dijon Bourgogne,Module Epidemiol Clin, Dijon, France

[17] Grp Courlancy, Cabinet Infectiol, Reims, France

[18] Univ Jules Verne, UR UPJV 7517, Amiens, France

[19] CHU Amiens Picardie, Amiens, France

[20] Inserm, CIC 1425, Paris, France

[21] Hop Bichat Claude Bernard, AP HP, Paris, France

[22] IAME, Inserm, UMR 1137, Paris, France

[23] Univ Paris Cite, UFR Med Bichat, Paris, France

[24] Univ Lorraine, Ecole Sante Publ, UR Apemac 4360, Ave Foret Haye, F-54505 Vandoeuvre Les Nancy, France

来源：

CLINICAL INFECTIOUS DISEASES | 2024年 / 78卷 / 04期

关键词：

infective endocarditis; 2023 Duke-ISCVID criteria; sensitivity; specificity; accuracy; BETH-ISRAEL CRITERIA;

D O I：

10.1093/cid/ciae035

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background The 2023 Duke-International Society for Cardiovascular Diseases (ISCVID) criteria for infective endocarditis (IE) were proposed as an updated diagnostic classification of IE. Using an open prospective multicenter cohort of patients treated for IE, we compared the performance of these new criteria to that of the 2000 Modified Duke and 2015 European Society of Cardiology (ESC) criteria. Methods Cases of patients treated for IE between January 2017 and October 2022 were adjudicated as certain IE or not. Each case was also categorized as either definite or possible/rejected within each classification. Sensitivity, specificity, and accuracy were estimated with 95% confidence intervals. Results Of the 1194 patients analyzed (mean age, 66.1 years; 71.2% males), 414 (34.7%) had a prosthetic valve and 284 (23.8%) had a cardiac implanted electronic device (CIED); 946 (79.2%) were adjudicated as certain IE; 978 (81.9%), 997 (83.5%), and 1057 (88.5%) were classified as definite IE in the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID criteria, respectively. The sensitivity of each set of criteria was 93.2% (95% confidence interval [CI], 91.6-94.8), 95.0% (95% CI, 93.7-96.4), and 97.6% (95% CI, 96.6-98.6), respectively (P < .001 for all 2-by-2 comparisons). Corresponding specificity rates were 61.3% (95% CI, 55.2-67.4), 60.5% (95% CI, 54.4-66.6), and 46.0% (95% CI, 39.8-52.2), respectively. In patients without CIED, sensitivity rates were 94.8% (95% CI, 93.2-96.4), 96.5% (95% CI, 95.1-97.8), and 97.7% (95% CI, 96.6-98.8); specificity rates were 59.0% (95% CI, 51.6-66.3), 56.6% (95% CI, 49.3-64.0), and 53.8% (95% CI, 46.3-61.2), respectively. Conclusions Overall, the 2023 Duke-ISCVID criteria had a significantly higher sensitivity but a significantly lower specificity compared with older criteria. This decreased specificity was mainly attributable to patients with CIED.

引用

页码：937 / 948

页数：12

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