ЕFFICACY OF ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION SYSTEM IN PATIENTS WITH INFECTIVE ENDOCARDITIS COMPLICATED BY ACUTE HEART FAILURE

Background. There is currently limited evidence on the effective management of intensive care for infective endocarditis (IE), including specific clinical signs that indicate a poor prognosis, as well as prognostic tools that are effective in identifying high-risk patients. Aim: Evaluate the effectiveness of using a severity assessment system in patients with infective endocarditis complicated by acute heart failure in the perioperative stage. Materials and methods. The study included clinical data of 75 patients with IE complicated by preoperative acute heart failure (AHF), who were hospitalised at the State Institution ‘Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine’ from 01.01.2019 to 01.01.2023. At the perioperative stage, clinical and biochemical parameters were assessed and scores were calculated according to the sepsis-associated organ dysfunction score. Results. The median calculated preoperative APACHE II score was 14 points (11;19). In our study, 23 patients (30.7%) belonged to the group with scores from 15 to 19. Surgical intervention under conditions of artificial circulation was performed in 72 (96.0%) cases. At the preoperative stage, hospital mortality was 3 (4.0%) patients with IE complicated by preoperative AHF. The median calculated APACHE II score on the first day of the postoperative period was 11 points (6;13). The distribution of patients based on the APACHE II scale was analysed. The largest number - 12 (16.7%) - of patients had a score of 13 on the APACHE II scale. The largest cohort at this stage was made up of patients with scores from ‘4’ to ‘9’ - 42 (58.3%) cases. In-hospital mortality in the surgical treatment of IE complicated by AHF was 10 (13.9%) cases. Conclusions. A balanced preoperative assessment of the risks of cardiac surgery will allow modifying the tactics of perioperative management of patients with IE complicated by preoperative AHF.