000K utf8 1100 2021$c2021-01-27 1500 eng 2050 urn:nbn:de:hbz:464-20210409-161604-1 2051 10.1016/j.ijid.2021.01.046 3000 Mahabadi, Amir A. 3010 Buer, Jan 3010 Dykun, Iryna 3010 Mahmoud, Ihab 3010 Rassaf, Tienush 3010 Rath, Peter-Michael 3010 Ruhparwar, Arjang 3010 Totzeck, Matthias 4000 Diagnostic value of the modified Duke criteria in suspected infective endocarditis - The PRO-ENDOCARDITIS study [Mahabadi, Amir A.] 4209 Objectives: To determine whether relevant comorbidities stratify patients with and without IE and whether these may improve the diagnostic accuracy, in addition to the modified Duke criteria. Methods and Results: 261 consecutive patients (aged 60.1 ± 16.1 years, 62.8% male) with suspected IE were prospectively included in this single-center observational trial. Modified Duke criteria and relevant comorbidities as well as clinical characteristics, were assessed. Forty-seven patients had IE, as confirmed by a clinical event committee. Patients with IE had a higher frequency of positive blood cultures (70.2% vs. 36.9%, p < 0.0001), embolic diseases (36.2% vs. 10.8%, p < 0.0001), heart murmurs (27.7% vs. 11.7%, p = 0.01), and intensive care therapy (74.5% vs. 58.4%, p = 0.04). In receiver operating characteristics, the combination of modified Duke criteria without transesophageal echocardiography led to an area under the curve of 0.783 (0.715-0.851). The predictive value was only marginally improved by the addition of heart murmur and intensive care therapy (0.794 [0.724-0.863]). In contrast, transesophageal echocardiography alone achieved an area under the curve of 0.956 (0.937-0.977) and was further improved when adding modified Duke criteria, heart murmur, and intensive care therapy (0.999 [0.998-1.000]). Conclusion: Modified Duke criteria provide excellent diagnostic value for evaluating suspected IE, mainly driven by transesophageal echocardiography. 4950 https://doi.org/10.1016/j.ijid.2021.01.046$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:464-20210409-161604-1$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00074081 5051 610 5550 Duke criteria 5550 Infective endocarditis 5550 Pre-test Probability 5550 Transesophageal echocardiography