Can the Glasgow prognostic score predict ischemic stroke in patients with infective endocarditis?

Cihan Aydın, Aykut Demirkıran, Hüseyin Aykaç, Nurullah Uslu, Şeref Alpsoy
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Abstract

SUMMARY OBJECTIVE: The Glasgow prognosis score is a simple parameter calculated using serum levels of albumin and C-reactive protein. The aim of this study was to examine whether this parameter may predict ischemic stroke in patients with infective endocarditis. METHODS: A total of 80 patients who were diagnosed with definitive infective endocarditis according to Duke criteria between 2016 and 2023 were included in the study. Glasgow prognosis score was based on serum levels of albumin and C-reactive protein. In imaging methods, patients were divided into two groups according to whether they had a stroke or not. These two groups were compared in terms of biochemical parameters, and infective endocarditis findings on echocardiography and Glasgow prognosis score. RESULTS: We found that the results were statistically similar except for serum C-reactive protein (Group 1: 54.9±71.1 and Group 2: 39±70.7; p=0.03), neutrophil (Group 1: 19.8±10.8*109/L and Group 2: 13.3±7.3*109/L; p=0.014), albumin (Group 1: 2.3±0.6 and Group 2: 2.8±0.5; p=0.03), and Glasgow prognosis score (Group 1: median 2, min.–max. (1–2) and Group 2: median 1, min.–max. (0–1); p=0.004). In the receiver operating characteristics analysis, Glasgow prognosis score had 82.4% sensitivity and 58.3% specificity in predicting ischemic stroke if the Glasgow prognosis score cutoff was ≥1. In multivariate logistic regression analysis, chronic renal failure [odds ratio (OR): 1.098; 95% confidence interval: 1.054–1.964; p=0.044], age (OR: 1.050; 95%CI 1.006–1.096; p=0.024), and Glasgow prognosis score (OR: 0.695; 95%CI 0.411–0.949; p=0.035) were independent variables in predicting ischemic stroke. CONCLUSION: High Glasgow prognosis score is an independent predictor of ischemic stroke in patients with infective endocarditis. Glasgow prognosis score, determined using albumin and C-reactive protein levels, is a simple and practical index for predicting the prognosis of patients hospitalized with infective endocarditis.
格拉斯哥预后评分能否预测感染性心内膜炎患者的缺血性中风?
摘要 目的:格拉斯哥预后评分是利用血清白蛋白和 C 反应蛋白水平计算得出的一个简单参数。本研究旨在探讨该参数是否可预测感染性心内膜炎患者的缺血性卒中。方法:研究共纳入了 80 名在 2016 年至 2023 年期间根据杜克标准确诊为明确感染性心内膜炎的患者。格拉斯哥预后评分基于血清白蛋白和C反应蛋白水平。在影像学方法方面,根据患者是否发生卒中将其分为两组。比较两组患者的生化指标、超声心动图上的感染性心内膜炎结果和格拉斯哥预后评分。结果:我们发现,除了血清 C 反应蛋白(第 1 组:54.9±71.1,第 2 组:39±70.7;P=0.03)、中性粒细胞(第 1 组:19.8±10.8*109/L,第2组:13.3±7.3*109/L;P=0.014)、白蛋白(第1组:2.3±0.6,第2组:2.8±0.5;P=0.03)、格拉斯哥预后评分(第1组:中位数2,最小值-最大值(1-2),第2组:最小值-最大值(1-2))。(1-2),第 2 组:中位数 1,最小 - 最大值。(0-1); p=0.004).在接受者操作特征分析中,如果格拉斯哥预后评分临界值≥1,格拉斯哥预后评分预测缺血性卒中的敏感性为 82.4%,特异性为 58.3%。098;95% 置信区间:1.054-1.964;p=0.044]、年龄(OR:1.050;95%CI 1.006-1.096;p=0.024)和格拉斯哥预后评分(OR:0.695;95%CI 0.411-0.949;p=0.035)是预测缺血性卒中的独立变量。结论:格拉斯哥预后评分高是感染性心内膜炎患者缺血性卒中的独立预测因素。利用白蛋白和 C 反应蛋白水平确定的格拉斯哥预后评分是预测感染性心内膜炎住院患者预后的一个简单实用的指标。
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