[Infective endocarditis in octogenarian patients]

Area of Science:

• Cardiology
• Geriatric Medicine
• Infectious Diseases

Background:

• Endocarditis is a serious infection affecting heart valves.
• Clinical presentation and prognosis of endocarditis can vary significantly with age.
• Limited data exists on endocarditis specifically in the oldest old (octogenarians).

Purpose of the Study:

• To compare the clinical features and prognosis of endocarditis in octogenarian patients (>79 years) versus younger elderly (65-79 years) and young (<65 years) patients.
• To identify factors influencing outcomes in different age groups.

Main Methods:

• Retrospective analysis of endocarditis patient data across three age groups: <65, 65-79, and >79 years.
• Clinical features, causative microorganisms, diagnostic findings (transesophageal echocardiography), treatment (surgery), and mortality were assessed.
• Statistical comparison between age cohorts.

Main Results:

• Octogenarians more frequently presented with community-acquired infections, mitral valve disease, and chronic anemia.
• Their clinical course was more insidious, with less frequent fever, new murmurs, and less severe heart failure.
• Streptococci were the most common pathogens; vegetation detection on echocardiography was lower in octogenarians.
• Octogenarians experienced shorter hospitalizations, less frequent surgery, and lower mortality rates.
• Mortality was not increased in elderly patients who underwent surgery.

Conclusions:

• Endocarditis in octogenarians exhibits a distinct, often less severe, clinical profile with a favorable prognosis.
• Despite a lower detection rate of vegetation, outcomes are generally better, and age is not an independent predictor of in-hospital mortality.
• These findings highlight the need for age-tailored management strategies for endocarditis.