Endocarditis in the elderly: clinical, echocardiographic, and prognostic features

Area of Science:

• Cardiology
• Infectious Diseases
• Geriatrics

Background:

• Infective endocarditis (IE) is increasingly prevalent in the elderly.
• IE in older populations exhibits distinct clinical, bacteriological, and prognostic profiles.

Purpose of the Study:

• To characterize the clinical, echocardiographic, and prognostic aspects of IE in a large cohort of elderly European patients.
• To compare these features with those observed in younger patient groups.

Main Methods:

• A multicenter study involving 315 patients with definite IE.
• Patients were stratified into three age groups: <50, 50-70, and >70 years.
• Data collected included clinical evaluation, echocardiography, blood cultures, and follow-up.

Main Results:

• Elderly patients more frequently presented with digestive/urinary portals of entry, pacemaker IE, and anemia.
• Staphylococcus bovis IE was less common, while Staphylococcus aureus IE was more frequent in younger patients.
• Mortality was higher in elderly patients (17%) compared to younger groups (10% and 7%), with age, prosthetic valves, and cerebral embolism identified as risk factors for in-hospital death.

Conclusions:

• Infective endocarditis in the elderly has specific clinical characteristics but similar echocardiographic findings and embolic risks compared to younger patients.
• Although overall mortality is higher in the elderly, surgical management is associated with reduced in-hospital mortality, comparable to younger patients.