{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:05:30Z","timestamp":1779771930582,"version":"3.53.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infective endocarditis (IE) carries high surgical mortality, particularly in Latin American populations where validated prediction models are scarce. Although EuroSCORE II, RISK-E, and APORTEI have shown acceptable performance in European cohorts, external validation in middle-income country settings remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adult patients who underwent cardiac surgery for IE at a high-complexity tertiary-care center in Bogot\u00e1, Colombia, between 2014 and 2025. The primary outcome was all-cause in-hospital mortality. Discrimination was assessed using Harrell's C-statistic and calibration was assessed via intercept, slope, Spiegelhalter's z-test, Brier score, mean absolute error (Eavg), and maximum absolute error (Emax).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy patients were included (mean age 51.9\u2009\u00b1\u200914.8 years; 70% male); in-hospital mortality was 30% (21\/70). RISK-E demonstrated the highest discrimination (C\u2009=\u20090.741, 95% CI 0.61\u20130.85), followed by EuroSCORE II (C\u2009=\u20090.718, 95% CI 0.58\u20130.83) and APORTEI (C\u2009=\u20090.676, 95% CI 0.53\u20130.80). All three scores systematically underestimated mortality risk, as evidenced by positive calibration intercepts (range 1.14\u20131.75). Calibration was closest to ideal for RISK-E (slope=0.962), while APORTEI showed the greatest deviation (slope=1.425). Spiegelhalter's z-test indicated significant miscalibration for all three models (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RISK-E showed numerically superior discrimination and a calibration slope closest to unity, although pairwise DeLong's tests showed no statistically significant difference between any two scores, and these findings should be interpreted in the context of the limited sample size (70 patients, 21 events). All three scores systematically underestimated in-hospital mortality, suggesting that recalibration or development of locally derived models is needed for reliable risk stratification in Latin American IE surgical programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1829289","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:43:30Z","timestamp":1779770610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Performance of predictive scores for in-hospital mortality in surgical infective endocarditis: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Paula Ximena","family":"Pavia-Velandia","sequence":"first","affiliation":[{"name":"Institute of Infectious Diseases and Tropical Medicine, M\u00e9deri Research Center (CIMED), Hospital Universitario Mayor M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Liliana","family":"Torres-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery, Hospital Universitario Mayor- M\u00e9deri","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00e1s","family":"Molano-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Clinical Research Group, School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaida","family":"Rodr\u00edguez-Villegas","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s","family":"Castillo-Valderrama","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabi\u00e1n Andr\u00e9s","family":"Guaque-Camargo","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Mariana","family":"Hidalgo-Su\u00e1rez","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Morales-Pertus","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases and Tropical Medicine, M\u00e9deri Research Center (CIMED), Hospital Universitario Mayor M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Ren\u00e9","family":"Rodr\u00edguez-Lima","sequence":"additional","affiliation":[{"name":"Clinical Research Group, School of Medicine and Health Sciences, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]},{"name":"Cardiac and Thoracic Institute, M\u00e9deri Research Center (CIMED), Hospital Universitario Mayor M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1016\/S0140-6736(15)00067-7","article-title":"Infective endocarditis","volume":"387","author":"Cahill","year":"2016","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"ehae666.1959","DOI":"10.1093\/eurheartj\/ehae666.1959","article-title":"Epidemiological profile and mortality of infective endocarditis over the past decade: a systematic review and meta-analysis of 133 studies comprising 132,355 cases","volume":"45","author":"Sagris","year":"2024","journal-title":"Eur Heart J"},{"key":"B3","first-page":"441","article-title":"Caracter\u00edsticas epidemiol\u00f3gicas de la endocarditis infecciosa. Experiencia de seis a\u00f1os","volume":"29","author":"Ariza","year":"2022","journal-title":"Rev Colomb Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC guidelines for the management of endocarditis","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1056\/NEJMcp1206782","article-title":"Infective endocarditis","volume":"368","author":"Hoen","year":"2013","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1161\/CIRCULATIONAHA.108.773598","article-title":"Surgery for infective endocarditis: who and when?","volume":"121","author":"Prendergast","year":"2010","journal-title":"Circulation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1093\/ejcts\/ezs043","article-title":"EuroSCORE II","volume":"41","author":"Nashef","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.1136\/heartjnl-2016-311093","article-title":"Risk score for cardiac surgery in active left-sided infective endocarditis","volume":"103","author":"Olmos","year":"2017","journal-title":"Heart"},{"key":"B9","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1093\/ejcts\/ezz328","article-title":"Prognostic assessment of valvular surgery in active infective endocarditis: multicentric nationwide validation of a new score developed from a meta-analysis","volume":"57","author":"Varela Barca","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2662","DOI":"10.21037\/jtd-2024-2041","article-title":"Infective endocarditis risk scores: a narrative review","volume":"17","author":"Cho","year":"2025","journal-title":"J Thorac Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.ijcard.2014.04.266","article-title":"Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis","volume":"175","author":"Mart\u00ednez-Sell\u00e9s","year":"2014","journal-title":"Int J Cardiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.ijcard.2017.03.148","article-title":"A predictive model for early mortality after surgical treatment of heart valve or prosthesis infective endocarditis. 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Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study","volume":"40","author":"Habib","year":"2019","journal-title":"Eur Heart J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.circv.2020.06.002","article-title":"Estimaci\u00f3n de la mortalidad quir\u00fargica de la endocarditis infecciosa: comparaci\u00f3n de las diferentes escalas espec\u00edficas de c\u00e1lculo de riesgo","volume":"27","author":"Varela","year":"2020","journal-title":"Cir Cardiovasc"},{"key":"B16","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.eimc.2020.05.012","article-title":"Prediction of surgical risk in patients with endocarditis: comparison of logistic EuroSCORE, EuroSCORE II and APORTEI score","volume":"39","author":"Urso","year":"2021","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"B17","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s10096-022-04516-2","article-title":"Risk scores\u2019 performance and their impact on operative decision-making in left-sided endocarditis: a cohort study","volume":"42","author":"Fern\u00e1ndez-Cisneros","year":"2023","journal-title":"Eur J Clin Microbiol Infect Dis"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1829289\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:43:41Z","timestamp":1779770621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1829289\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":17,"alternative-id":["10.3389\/fcvm.2026.1829289"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1829289","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"article-number":"1829289"}}