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Infective endocarditis in octogenarians-a multicenter analysis†
Shekhar Saha1, Carolyn Weber2, Mateo Marin-Cuartas3
1Department of Cardiac Surgery, Ludwig Maximillian University of Munich, Munich, Germany.
Summary
Infective endocarditis (IE) in octogenarians presents uniquely with higher surgical risks and distinct microbiological profiles. Despite increased mortality, advanced age alone should not preclude surgery for IE in the elderly.
Area of Science:
- Cardiology
- Infectious Diseases
- Geriatrics
Background:
- Infective endocarditis (IE) exhibits unique clinical presentations in older populations.
- Understanding these differences is crucial for effective management.
Purpose of the Study:
- To investigate the clinical presentation, microbiological profile, and outcomes of IE specifically in octogenarians.
- To compare these factors with a younger cohort.
Main Methods:
- Multicentre retrospective analysis of 4917 consecutive IE patients.
- Focused analysis on 292 octogenarian patients undergoing surgery for IE.
- Primary outcomes: 30-day mortality and 5-year survival.
Main Results:
- Octogenarians (5.9%) had higher median EuroSCORE II, prosthetic valve endocarditis, and pacemaker endocarditis.
- Streptococcal infections were more frequent in octogenarians; blood culture-negative IE was higher in younger patients.
- 30-day mortality was significantly higher in octogenarians (P < 0.001), with 1- and 5-year survival rates of 48% and 39% respectively.
Conclusions:
- IE in the elderly presents with a different clinical profile and is associated with higher risks.
- Advanced age impacts IE surgery outcomes but should not be the sole contraindication for surgical intervention.
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