virsta_score: VIRSTA Score for Infective Endocarditis

In cliot: Clinical Indices and Outcomes Tools

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)

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).

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.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.