Compared Performance of the 2023 Duke-International Society for Cardiovascular Infectious Diseases, the 2000 Modified Duke, and the 2015 ESC Criteria for the Diagnosis of Infective Endocarditis in a French Multicenter Prospective Cohort - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Clinical Infectious Diseases Année : 2024

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

Francois Goehringer
  • Fonction : Auteur
Benoit Lalloue
  • Fonction : Auteur
Christine Selton-Suty
  • Fonction : Auteur
Elisabeth Botelho-Nevers
Catherine Chirouze
  • Fonction : Auteur
Elodie Curlier
  • Fonction : Auteur
Safwane El Hatimi
  • Fonction : Auteur
Amandine Gagneux-Brunon
  • Fonction : Auteur
Vincent Le Moing
  • Fonction : Auteur
Pascal Lim
  • Fonction : Auteur
Lionel Piroth
  • Fonction : Auteur
Christophe Strady
  • Fonction : Auteur
Jean-Marc Virion
  • Fonction : Auteur
Nelly Agrinier
  • Fonction : Auteur
Xavier Duval
  • Fonction : Auteur
Bruno Hoen
  • Fonction : Auteur

Résumé

BACKGROUND: The 2023 Duke-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 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% men), 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% [91.6-94.8], 95.0% [93.7-96.4], and 97.6% [96.6-98.6], respectively (p<.001 for all 2-by-2 comparisons). Corresponding specificity rates were 61.3% [55.2-67.4), 60.5% [54.4-66.6], and 46.0% [39.8-52.2], respectively. In patients without CIED, sensitivity rates were 94.8% [93.2-96.4], 96.5% [95.1-97.8], and 97.7% [96.6-98.8] and specificity rates were 59.0% [51.6-66.3], 56.6% [49.3-64.0], and 53.8% [46.3-61.2], respectively. CONCLUSION: Overall, the 2023 Duke-ISCVID criteria had a significantly higher sensitivity but a significantly lower specificity, compared to older criteria. This decreased specificity was mainly attributable to patients with CIED.
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Dates et versions

hal-04505092 , version 1 (14-03-2024)

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Francois Goehringer, Benoit Lalloue, Christine Selton-Suty, Francois Alla, Elisabeth Botelho-Nevers, et al.. Compared Performance of the 2023 Duke-International Society for Cardiovascular Infectious Diseases, the 2000 Modified Duke, and the 2015 ESC Criteria for the Diagnosis of Infective Endocarditis in a French Multicenter Prospective Cohort. Clinical Infectious Diseases, 2024, ⟨10.1093/cid/ciae035⟩. ⟨hal-04505092⟩
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