Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

Modeling the impact of oyster culture on a mudflat food web in Marennes-Oléron Bay (France)

International audienceWe used a carbon-based food web model to investigate the effects of oyster cultivation on the ecosystem of an intertidal mudflat. A previously published food web model of a mudflat in Marennes-Oléron Bay, France, was updated with revised parameters, and a realistic surface area and density of existing oyster cultures on the mudflat. We developed 2 hypothetical scenarios to estimate the impact of oyster cultivation on the food web structure of the ecosystem: one with no oysters, the other with a doubled area devoted to cultivated oysters in the bay. Oysters are direct trophic competitors of other filter feeders, and their presence modifies benthic-pelagic coupling by forcing a shift from pelagic consumers to benthic consumers. Increasing the surface area of cultivated oysters caused secondary production to increase, providing food for top predators (in particular juvenile nekton), reinforcing the nursery role of the mudflat in the ecosystem, and altering the species composition available to the top predators

Evaluation of the coronary flow between the left and the right coronary network in patients with triple vessel disease with chronically occluded right coronary artery

International audienc