Prognostic Scores for Mortality in Cardiac Surgery for Infective Endocarditis

The article by Pivatto F Jr et al. allows us to discuss the important issue of prognostic scores in patients who have cardiac surgery for infective endocarditis (IE). The management of left- sided IE often involves surgery during the index admission, and the main challenge is to rapidly and correctly identify patients at high risk and to transfer them to institutions with a surgical team with expertise in endocarditis surgery.

Prognostic scores are important for several reasons: a reasonable estimate of the risk of death is important in clinical decision-making regarding surgical indication; the estimate is necessary to inform patients and their families of the surgical risk; risk stratification permits a fair comparison of cardiac surgery results, so that surgeons and hospitals treating high-risk patients will not appear to have worse results than others. For operative mortality to remain a valid measure of quality of care, it must be related to the risk profile of the patients receiving surgery.

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