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Evaluation of the 2023 Duke-ISCVID criteria for infective endocarditis in patients referred to the Lund infective endocarditis team

Avogadri, Nils ; Ivarsson, Alex ; Burup Kristensen, Charlotte LU orcid ; Ragnarsson, Sigurdur LU and Rasmussen, Magnus LU orcid (2024) In Infectious Diseases
Abstract

Background: The Duke criteria for diagnosing infective endocarditis (IE) were recently updated by the International Society for Cardiovascular Infectious Diseases (ISCVID) with the purpose of enhancing diagnostic specificity and sensitivity. This study investigated the performance of the Duke-ISCVID criteria in relation to previous criteria. Method: This retrospective single centre cohort study included patients referred to the Lund IE Team (LIET) between 2017 and 2022, and compared episodes classified according to the 2000 modified Duke, European Society of Cardiology (ESC) 2015, and 2023 Duke-ISCVID criteria. The LIET's decision to treat episodes as IE served as the reference standard. Results: The study cohort comprised 661 episodes... (More)

Background: The Duke criteria for diagnosing infective endocarditis (IE) were recently updated by the International Society for Cardiovascular Infectious Diseases (ISCVID) with the purpose of enhancing diagnostic specificity and sensitivity. This study investigated the performance of the Duke-ISCVID criteria in relation to previous criteria. Method: This retrospective single centre cohort study included patients referred to the Lund IE Team (LIET) between 2017 and 2022, and compared episodes classified according to the 2000 modified Duke, European Society of Cardiology (ESC) 2015, and 2023 Duke-ISCVID criteria. The LIET's decision to treat episodes as IE served as the reference standard. Results: The study cohort comprised 661 episodes of potential IE. The LIET classified 498 (75%) episodes as IE. The Duke-ISCVID criteria classified a slightly higher proportion of episodes as definite IE (56.4%) compared to the ESC 2015 criteria (54.9%), and the modified Duke (51.1%). The Duke-ISCVID criteria had higher sensitivity (72.5%) for definite IE compared to ESC 2015 (70.7%, p =.57) and modified Duke (66.1%, p =.033). The specificities were similar for the Duke-ISCVID criteria (92.6%), compared to ESC 2015 (93.9%, p =.83) and the modified Duke criteria (95.0%, p =.49). When considering both definite and possible IE positive, specificity for all criteria was low: 32.5% for the Duke-ISCVID criteria, 41.7% for ESC 2015 (p =.086), and 42.3% for modified Duke criteria (p =.11), while the sensitivity was not significantly lower. Discussion: The Duke-ISCVID criteria demonstrated slightly improved sensitivity for diagnosing IE whereas specificity remained unchanged. Further refinement of the Duke-ISCVID criteria is needed to balance sensitivity and specificity.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Duke criteria, Infective endocarditis, ISCVID, single centre cohort study, validation study
in
Infectious Diseases
publisher
Informa Healthcare
external identifiers
  • scopus:85204009692
  • pmid:39269886
ISSN
2374-4235
DOI
10.1080/23744235.2024.2402374
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
id
1ebcc45a-ab3e-49c3-8da3-b687af0dc864
date added to LUP
2024-12-02 14:47:28
date last changed
2024-12-16 16:17:36
@article{1ebcc45a-ab3e-49c3-8da3-b687af0dc864,
  abstract     = {{<p>Background: The Duke criteria for diagnosing infective endocarditis (IE) were recently updated by the International Society for Cardiovascular Infectious Diseases (ISCVID) with the purpose of enhancing diagnostic specificity and sensitivity. This study investigated the performance of the Duke-ISCVID criteria in relation to previous criteria. Method: This retrospective single centre cohort study included patients referred to the Lund IE Team (LIET) between 2017 and 2022, and compared episodes classified according to the 2000 modified Duke, European Society of Cardiology (ESC) 2015, and 2023 Duke-ISCVID criteria. The LIET's decision to treat episodes as IE served as the reference standard. Results: The study cohort comprised 661 episodes of potential IE. The LIET classified 498 (75%) episodes as IE. The Duke-ISCVID criteria classified a slightly higher proportion of episodes as definite IE (56.4%) compared to the ESC 2015 criteria (54.9%), and the modified Duke (51.1%). The Duke-ISCVID criteria had higher sensitivity (72.5%) for definite IE compared to ESC 2015 (70.7%, p =.57) and modified Duke (66.1%, p =.033). The specificities were similar for the Duke-ISCVID criteria (92.6%), compared to ESC 2015 (93.9%, p =.83) and the modified Duke criteria (95.0%, p =.49). When considering both definite and possible IE positive, specificity for all criteria was low: 32.5% for the Duke-ISCVID criteria, 41.7% for ESC 2015 (p =.086), and 42.3% for modified Duke criteria (p =.11), while the sensitivity was not significantly lower. Discussion: The Duke-ISCVID criteria demonstrated slightly improved sensitivity for diagnosing IE whereas specificity remained unchanged. Further refinement of the Duke-ISCVID criteria is needed to balance sensitivity and specificity.</p>}},
  author       = {{Avogadri, Nils and Ivarsson, Alex and Burup Kristensen, Charlotte and Ragnarsson, Sigurdur and Rasmussen, Magnus}},
  issn         = {{2374-4235}},
  keywords     = {{Duke criteria; Infective endocarditis; ISCVID; single centre cohort study; validation study}},
  language     = {{eng}},
  publisher    = {{Informa Healthcare}},
  series       = {{Infectious Diseases}},
  title        = {{Evaluation of the 2023 Duke-ISCVID criteria for infective endocarditis in patients referred to the Lund infective endocarditis team}},
  url          = {{http://dx.doi.org/10.1080/23744235.2024.2402374}},
  doi          = {{10.1080/23744235.2024.2402374}},
  year         = {{2024}},
}