NEW DIAGNOSTIC-CRITERIA FOR INFECTIVE ENDOCARDITIS - A STUDY OF SENSITIVITY AND SPECIFICITY

Objective The purpose of this study was to determine the sensitivity a nd specificity of new criteria proposed by Duke University for case de finition of infective endocarditis as compared to the previously accep ted Von Reyn criteria. Patients A total of 143 consecutive suspected c ases of infective endocarditis in 137 febrile patients were included. Of these, 69 had infective endocarditis, pathologically proven in 28, but with only a clinical diagnosis in 41. In the remaining 74 cases, t he diagnosis of infective endocarditis was rejected after a follow-up of at least 3 months. Results The sensitivity of Duke's criteria was s ignificantly higher, both when patients with possible infective endoca rditis were considered as true-positive (definition 1; 100% vs 69%, P< 0.001) and when possible cases were considered as rejected (definition 2; 76% vs 51%, P<0.01). Specificity was very high with both criteria: 92% Von Reyn vs 88% Duke (ns) with definition 1 and 99% Von Reyn vs 9 7% Duke (ns) with definition 2. The overall accuracy of the Duke crite ria in the entire population was significantly higher with both defini tions (0.94 vs 0.81 definition 1, P<0.001; 0.87 vs 0.75, P=0.015 defin ition 2). Conclusion Duke's criteria for defining infective endocardit is has been shown to be more sensitive than previously adopted criteri a, while maintaining a high degree of specificity. Therefore, they mus t be accepted as a substitute for previous criteria.