Age-Dependent Profile of Left-Sided Infective Endocarditis

Abstract

Background-The influence of age on the main epidemiological, clinical, echocardiographic, microbiological, and prognostic features of patients with infective endocarditis remains unknown. We present the series with the largest numbers and range of ages of subjects to date that analyzes the influence of age on the main characteristics of patients with isolated left-sided infective endocarditis. Furthermore, this series is the first one in which patients have been distributed according to age quartile. Methods and Results-A total of 600 episodes of left-sided endocarditis consecutively diagnosed in 3 tertiary centers were stratified into age-specific quartiles and 107 variables compared between the different groups. With increasing age, the percentage of women, previous heart disease, predisposing disease (diabetes mellitus and cancer), and infection by enterococci and Streptococcus bovis also increased. Valvular insufficiency and perforation and Staphylococcus aureus infection were more common in younger patients. The therapeutic approach differed depending on patient age because of the growing proportion of older patients who only received medical treatment. Clinical course and hospital prognosis were worse in the older patients because of increased surgical mortality among them. Conclusions-Increasing age is associated with less valvular impairment (insufficiency and perforation), a more favorable microbiological profile, and increased surgical mortality among adults with left-sided infective endocarditis. (Circulation. 2010;121:892-897.)

Epidemiology of infective endocarditis in a tertiary-center in Jerusalem: A 3-year prospective survey

“…(iv) The median age in our cohort (63 years) was higher than that reported in the ICE-PCS cohort (57.9 years) [5]. An older patient population was associated in this study as well as in others with increased mortality rate due to increased rate of comorbidities, and nosocomial IE [3,5,25,27].…”

“…Former studies had already defined early surgery and a low threshold for surgery as critical factors in improving survival in IE patients [5,19,28]. Interestingly, the unique features of our cohort could indirectly contribute to the high mortality rate; patients with diabetes mellitus are less frequently referred to surgery [23], surgical intervention is more commonly indicated in prosthetic valve endocarditis than in native valve infection [29], patients with health care-associated-IE undergo surgery less frequently than community acquired IE [30], and the percentage of surgically treated patients decreases with increasing age [27].…”

Surgical treatment for infective endocarditis in elderly patients

“…11,12 This fact can be due, in part, to the greater prevalence of episodes affecting aortic bicuspid valves in younger males and also to the greater life expectancy of women in our country.…”

Infective endocarditis

“…В таблице 1 обобщены сведения о возбудителях ИЭ у пожилых больных по данным различных иссле-дований, выполненных за последние годы [25,[31][32][33][34][35][36][37]. (6) 60 (17) 32 (11) Другие стрептококки 22 (25) 16 (19) 14 (5) 20 (6 …”