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[Infective endocarditis in the elderly].

J M Cruz¹, R Martínez, M García

¹Servicio de Medicina Interna, Hospital Cristal-Piñor, Ourense.

Anales De Medicina Interna (Madrid, Spain : 1984)

|November 20, 2003

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Age does not negatively impact infective endocarditis (IE) prognosis. Elderly patients with IE showed similar outcomes and treatment frequency compared to younger adults, indicating age alone is not a poor prognostic factor.

Area of Science:

Cardiology
Infectious Diseases
Geriatrics

Background:

The impact of aging on infective endocarditis (IE) presentation and prognosis remains unclear.
Investigating IE in elderly versus younger adults is crucial for understanding age-related differences.

Purpose of the Study:

To compare epidemiologic, clinical, and bacteriological characteristics of IE in elderly (>65 years) versus younger (20-64 years) adult patients.
To analyze the influence of age on IE diagnosis, treatment, and outcomes.

Main Methods:

Retrospective study of non-intravenous drug user IE patients from 1990-2000.
Utilized Duke criteria to compare 46 elderly IE episodes with 46 younger adult IE episodes.
Assessed diagnostic methods like echocardiography and treatment approaches.

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Main Results:

No significant differences in diagnosis delay, infection source, positive blood cultures, or IE evolution between age groups.
Elderly patients had more predisposing risk factors, reducing transthoracic echocardiography sensitivity.
Transesophageal echocardiography improved IE diagnosis in 37.2% of elderly patients.
Similar surgical therapy rates and no significantly higher mortality in the elderly (19.5%) versus younger adults (10.8%).

Conclusions:

Age is not an independent poor prognostic factor for infective endocarditis.
Early and aggressive treatment should not be withheld from elderly IE patients based solely on age.