METHODS: Conducted retrospectively at two Swiss University Hospitals between 2014-2023, the study involved patients with suspected IE. Each hospitals\' Endocarditis Team categorized case as either IE or not IE. The performance of each iteration of the Duke-ESC clinical criteria was assessed based on the agreement between definite IE and the diagnoses made by the Endocarditis Team.
RESULTS: Among the 3127 episodes with suspected IE, 1177 (38%) were confirmed to have IE. Using the 2015 Duke-ESC clinical criteria, 707 (23%) episodes were deemed definite IE, with 696 (98%) receiving a final IE diagnosis. With the 2023 Duke-ESC clinical criteria, 855 (27%) episodes were classified as definite IE, of which 813 (95%) were confirmed as IE. The 2015 and 2023 Duke-ESC clinical criteria categorized 1039 (33%) and 1034 (33%) episodes, respectively, as possible IE. Sensitivity for the 2015 Duke-ESC and the 2023 Duke-ESC clinical criteria was calculated at 59% (95% CI: 56-62%), and 69% (66-72%), respectively, with specificity at 99% (99-100%), and 98% (97-98%), respectively.
CONCLUSIONS: The 2023 ESC criteria demonstrated significant improvements in sensitivity compared to the 2015 version, although one-third of episodes were classified as possible IE by both versions.
方法:2014-2023年在两家瑞士大学医院进行了回顾性研究,该研究涉及疑似IE患者。各医院心内膜炎小组将病例分类为IE或非IE。根据明确的IE与心内膜炎小组的诊断之间的一致性,评估Duke-ESC临床标准的每次迭代的性能。
结果:在3127例疑似IE发作中,1177(38%)被确认为IE。使用2015年Duke-ESC临床标准,707(23%)次发作被认为是明确的IE,696人(98%)接受了最终的IE诊断。根据2023年Duke-ESC临床标准,855(27%)次发作被归类为明确IE,其中813人(95%)被确认为IE。2015年和2023年Duke-ESC临床标准分为1039例(33%)和1034例(33%)。分别,尽可能的IE。2015年Duke-ESC和2023年Duke-ESC临床标准的敏感性计算为59%(95%CI:56-62%),和69%(66-72%),分别,特异性为99%(99-100%),和98%(97-98%),分别。
结论:与2015年版本相比,2023年ESC标准显示出灵敏度的显着提高,尽管两种版本都将三分之一的情节归类为可能的IE。