cliot (version 1.0.0)

virsta_score: VIRSTA Score for Infective Endocarditis

Description

Calculates the VIRSTA score to predict the risk of Infective Endocarditis (IE) in patients with Staphylococcus aureus bacteremia. The score helps identify patients at low risk for whom Transesophageal Echocardiography (TEE) might be safely avoided.

Usage

virsta_score(cerebral_emboli, meningitis, permanent_intracardiac_device,
             history_infective_endocarditis, vertebral_osteomyelitis,
             preexisting_native_valve_disease, intravenous_drug_use,
             severe_sepsis_shock, crp_mg_l, community_acquired)

Value

A list containing:

VIRSTA_Score

The calculated total score.

Risk_Category

Risk classification (Low vs. High).

Recommendation

Clinical guidance regarding the need for TEE.

Arguments

cerebral_emboli

Numeric (0 or 1). Presence of cerebral emboli (clinical or imaging). (1 = Yes, +5 points).

meningitis

Numeric (0 or 1). Presence of meningitis. (1 = Yes, +4 points).

permanent_intracardiac_device

Numeric (0 or 1). Presence of a permanent intracardiac device (e.g., prosthetic valve, pacemaker, ICD). (1 = Yes, +4 points).

history_infective_endocarditis

Numeric (0 or 1). Previous history of infective endocarditis. (1 = Yes, +3 points).

vertebral_osteomyelitis

Numeric (0 or 1). Presence of vertebral osteomyelitis. (1 = Yes, +3 points).

preexisting_native_valve_disease

Numeric (0 or 1). Pre-existing native valve disease. (1 = Yes, +3 points).

intravenous_drug_use

Numeric (0 or 1). Intravenous drug use. (1 = Yes, +2 points).

severe_sepsis_shock

Numeric (0 or 1). Presence of severe sepsis or septic shock. (1 = Yes, +1 point).

crp_mg_l

Numeric. C-Reactive Protein level in mg/L. (>= 190 mg/L adds +2 points).

community_acquired

Numeric (0 or 1). Is the bacteremia community-acquired? (1 = Yes, +1 point).

References

Delahaye F, et al. Prediction of Infective Endocarditis in Patients with Staphylococcus aureus Bacteremia: The VIRSTA Score. J Am Coll Cardiol. 2016;67(20):2305-2314.

Examples

# Example 1: High Risk
# Pacemaker (+4), Fever/Sepsis (+1), Community Acquired (+1) -> Score 6
virsta_score(0, 0, 1, 0, 0, 0, 0, 1, 50, 1)

# Example 2: Low Risk
# Community Acquired (+1), CRP 100 (0), No other factors -> Score 1
virsta_score(0, 0, 0, 0, 0, 0, 0, 0, 100, 1)