Background Diagnosing infective endocarditis (IE) poses a significant challenge. This study aimed to compare the diagnostic accuracy of the 2015 and 2023 Duke clinical criteria introduced by the European Society of Cardiology (ESC) in a cohort of patients suspected of having IE. Methods Conducted retrospectively at two Swiss University Hospitals between 2014-2023, the study involved patients with suspected IE. Each hospitals’ Endocarditis Team categorized case as either IE or not IE. The performance of each iteration of the Duke-ESC clinical criteria was assessed based on the agreement between definite IE and the diagnoses made by the Endocarditis Team. Results Among the 3127 episodes with suspected IE, 1177 (38%) were confirmed to have IE. Using the 2015 Duke-ESC clinical criteria, 707 (23%) episodes were deemed definite IE, with 696 (98%) receiving a final IE diagnosis. With the 2023 Duke-ESC clinical criteria, 855 (27%) episodes were classified as definite IE, of which 813 (95%) were confirmed as IE. The 2015 and 2023 Duke-ESC clinical criteria categorized 1039 (33%) and 1034 (33%) episodes, respectively, as possible IE. Sensitivity for the 2015 Duke-ESC and the 2023 Duke-ESC clinical criteria was calculated at 59% (95% CI: 56-62%), and 69% (66-72%), respectively, with specificity at 99% (99-100%), and 98% (97-98%), respectively. Conclusions The 2023 ESC criteria demonstrated significant improvements in sensitivity compared to the 2015 version, although one-third of episodes were classified as possible IE by both versions.

中文翻译：

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2015 年和 2023 年欧洲心脏病学会版本的杜克标准在疑似感染性心内膜炎患者中的比较


背景 诊断感染性心内膜炎 (IE) 提出了重大挑战。本研究旨在比较欧洲心脏病学会 (ESC) 推出的 2015 年和 2023 年杜克临床标准对疑似 IE 患者队列的诊断准确性。方法 该研究于 2014 年至 2023 年期间在两所瑞士大学医院进行回顾性研究，涉及疑似 IE 患者。各医院的心内膜炎小组将病例分为 IE 或非 IE。 Duke-ESC 临床标准每次迭代的表现都是根据明确的 IE 与心内膜炎团队做出的诊断之间的一致性进行评估的。结果 3127 例疑似 IE 病例中，1177 例（38%）确诊为 IE。使用 2015 年 Duke-ESC 临床标准，707 例 (23%) 发作被视为明确的 IE，其中 696 例 (98%) 接受最终 IE 诊断。根据2023年Duke-ESC临床标准，855例（27%）发作被归类为明确的IE，其中813例（95%）被确认为IE。 2015 年和 2023 年 Duke-ESC 临床标准分别将 1039 (33%) 和 1034 (33%) 次发作归类为可能的 IE。计算得出 2015 年 Duke-ESC 和 2023 年 Duke-ESC 临床标准的敏感性分别为 59% (95% CI: 56-62%) 和 69% (66-72%)，特异性为 99% (99分别为 -100%) 和 98% (97-98%)。结论 2023 年 ESC 标准显示，与 2015 年版本相比，敏感性显着提高，尽管两个版本都有三分之一的发作被归类为可能的 IE。