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Infective endocarditis in octogenarians. A retrospective study in a single, high-volume surgical centre
Valentina Scheggi1, Silvia Menale2,3, Barbara Tonietti4
1Cardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. scheggiv@aou-careggi.toscana.it.
BMC Geriatrics
|October 13, 2023
Summary
Elderly patients with infective endocarditis (IE) present unique challenges. Disability and surgical exclusion, not age, predict mortality in octogenarians with IE.
Area of Science:
- Cardiology
- Geriatrics
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a severe condition with high mortality.
- Management of IE in elderly patients, particularly octogenarians, remains poorly understood.
- Surgical intervention in older adults with IE can be complex.
Purpose of the Study:
- To characterize IE features in octogenarians.
- To identify independent predictors of mortality in elderly IE patients.
- To assess the prognostic impact of disability on outcomes in octogenarian IE.
Main Methods:
- Retrospective analysis of 551 patients with non-device-related IE.
- Comparison of 97 octogenarian patients (≥80 years) with younger patients.
- Statistical analysis to identify independent predictors of mortality.
Main Results:
- Octogenarians showed a higher prevalence of female gender and Enterococcal infections.
- Elderly patients had more comorbidities, higher EuroSCORE II, and were more frequently left-sided IE.
- Octogenarians were more often excluded from surgery and had higher three-year mortality.
Conclusions:
- Octogenarians with IE exhibit distinct clinical and microbiological profiles.
- Exclusion from surgery and high disability grade independently predict mortality in elderly IE patients.
- Age alone should not preclude surgery; disability is a key prognostic indicator.
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