Infective endocarditis in elderly and very elderly patients

Abstract

Aims

To compare the clinical and epidemiological characteristics and the evolution of infective endocarditis in adults aged under 65 years, 65–79 years, and 80 years or older.

Methods

An observational retrospective cohort study in patients with infective endocarditis was performed in a public hospital in Spain from January 2013 to December 2017.

Results

Seventy-two patients were treated: 26 (36.1%) were under 65 years old, 28 (38.9%) were 65–79 years old, and 18 (25%) were aged 80 or older. Prosthetic valve endocarditis was less common in patients aged 65–79 years (3.6%) than in younger (23.1%; p = 0.047) or older (38.9%; p = 0.004) patients. In contrast, degenerative heart disease was more prevalent in the 65–79 year age group [64.3% compared to 15.4% (p < 0.001) in the youngest group, and 33.3% (p = 0.04) in the oldest]. Surgical interventions were similar in patients aged 65–79 (50%) and under 65 years (42.3%), but less common in people over 80 years (16.7%; p = 0.022).

Conclusions

The characteristics of infective endocarditis are different in patients aged 65–79 years and in those over 80 years.

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Data availability

Data are available from the authors upon reasonable request

References

  1. 1.

    Bin Abdulhak AA, Baddour LM, Erwin PJ et al (2014) Global and regional burden of infective endocarditis, 1990–2010. Glob Heart 9:131–143

    Article  Google Scholar 

  2. 2.

    Tleyjeh IM, Abdel-Latif A, Rahbi H et al (2007) A systematic review of population-based studies of infective endocarditis. Chest 132:1025–1035

    Article  Google Scholar 

  3. 3.

    Fernández-Hidalgo N, Tornos Mas P (2013) Epidemiology of infective endocarditis in Spain in the last 20 years. Rev Española Cardiol 66:728–733

    Article  Google Scholar 

  4. 4.

    Ursi MP, Durante Mangoni E, Rajani R et al (2019) Infective endocarditis in the elderly: diagnostic and treatment options. Drugs Aging 36:115–124

    CAS  Article  Google Scholar 

  5. 5.

    Slipczuk L, Codolosa JN, Davila CD et al (2013) Infective endocarditis epidemiology over five decades: a systematic review. PLoS One 8:e82665

    Article  Google Scholar 

  6. 6.

    Coffey S, Cox B, Williams MJ (2014) Lack of progress in valvular heart disease in the pre-transcatheter aortic valve replacement era: increasing deaths and minimal change in mortality rate over the past three decades. Am Heart J 167:562–567

    Article  Google Scholar 

  7. 7.

    Peled N, Pitlik S, Livni G et al (2006) Impact of age on clinical features and outcome of infective endocarditis. Eur J Clin Microbiol Infect Dis 25:473–475

    CAS  Article  Google Scholar 

  8. 8.

    Castillo JC, Anguita MP, Ramírez A et al (2000) Clinical features and prognosis of infective endocarditis in the elderly. Rev Esp Cardiol 53:1437–1442

    Article  Google Scholar 

  9. 9.

    Durante-Mangoni E, Bradley S, Selton-Suty C et al (2008) Current features of infective endocarditis in elderly patients: results of the international collaboration on endocarditis prospective cohort study. Arch Intern Med 168:2095–2103

    Article  Google Scholar 

  10. 10.

    López J, Revilla A, Vilacosta I et al (2010) Age-dependent profile of left-sided infective endocarditis: a 3-center experience. Circulation 121:892–897

    Article  Google Scholar 

  11. 11.

    Werner GS, Schulz R, Fuchs JB et al (1996) Infective endocarditis in the elderly in the era of transesophageal echocardiography: clinical features and prognosis compared with younger patients. Am J Med 100:90–97

    CAS  Article  Google Scholar 

  12. 12.

    López-Wolf D, Vilacosta I, San Román JA et al (2011) Endocarditis infecciosa en pacientes octogenarios. Rev Esp Cardiol 64:329–333

    Article  Google Scholar 

  13. 13.

    Armiñanzas C, Fariñas-Alvarez C, Zarauza J et al (2019) Role of age and comorbidities in mortality of patients with infective endocarditis. Eur J Intern Med 64:63–71

    Article  Google Scholar 

  14. 14.

    Selton-Suty C, Hoen B, Grentzinger A et al (1997) Clinical and bacteriological characteristics of infective endocarditis in the elderly. Heart 77:260–263

    CAS  Article  Google Scholar 

  15. 15.

    Terpenning MS, Buggy BP, Kauffman CA (1987) Infective endocarditis: clinical features in young and elderly patients. Am J Med 83:626–634

    CAS  Article  Google Scholar 

  16. 16.

    Li JS, Sexton DJ, Mick N et al (2000) Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30:633–638

    CAS  Article  Google Scholar 

  17. 17.

    Cresti A, Chiavarelli M, Scalese M et al (2017) Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study. Cardiovasc Diagn Ther 7:27–35

    Article  Google Scholar 

  18. 18.

    Prendki V (2019) Management of elderly patients with infective endocarditis. Clin Microbiol Infect S1198–743X:30368–30374

    Google Scholar 

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Acknowledgements

We thank the staff at the Infectious Diseases Unit, the Cardiology Service and the Cardiac Surgery Service for their participation in caring for the patients. We gratefully acknowledge the assistance of Meggan Harris in translating our manuscript from Spanish.

Funding

The authors did not receive funding for this study.

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Affiliations

Authors

Contributions

MME: data collection, data analysis, manuscript writing, and final manuscript approval. JMRR: study conception, study, design, data analysis, manuscript writing, and final manuscript approval. EML: data collection, data analysis, manuscript writing, and final manuscript approval. SEB: data collection, data analysis, and final manuscript approval. DTT: data collection, data analysis, and final manuscript approval. VCP: data collection, data analysis, and final manuscript approval. VB: manuscript writing and final manuscript approval. JPS: study conception, study design, data collection, data analysis, manuscript writing, and final manuscript approval.

Corresponding author

Correspondence to José M. Ramos-Rincón.

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Conflict of interests

All authors report no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethical Committee of the General University Hospital of Alicante (CEIm PI 2018/105) and with the 1964 Helsinki declaration. The study was not conducted with animals.

Informed consent

The Ethics Committee approved an exception to the rules on informed consent because it was a retrospective study.

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Menchi-Elanzi, M., Ramos-Rincón, J.M., Merino-Lucas, E. et al. Infective endocarditis in elderly and very elderly patients. Aging Clin Exp Res 32, 1383–1388 (2020). https://doi.org/10.1007/s40520-019-01314-3

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Keywords

  • Bacterial endocarditis
  • Cardiovascular infection
  • Elderly
  • Very elderly
  • Mortality