Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes
In the context of the increased incidence of infectious endocarditis (IE) in the elderly, an assessment of clinical features of IE in elderly patients is still controversial.Aim. To study the clinical features and outcomes of IE in patients aged ≥65 years.Material and methods. А comparative assessme...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Столичная издательская компания
2020-05-01
|
| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/2155 |
| _version_ | 1826949600384122880 |
|---|---|
| author | N. S. Chipigina N. Yu. Karpova D. A. Anichkov T. B. Kondratieva |
| author_facet | N. S. Chipigina N. Yu. Karpova D. A. Anichkov T. B. Kondratieva |
| author_sort | N. S. Chipigina |
| collection | DOAJ |
| description | In the context of the increased incidence of infectious endocarditis (IE) in the elderly, an assessment of clinical features of IE in elderly patients is still controversial.Aim. To study the clinical features and outcomes of IE in patients aged ≥65 years.Material and methods. А comparative assessment of risk factors, etiology, clinical manifestations, outcomes was performed in 75 IE patients ≥65 years old and in 356 IE patients <65 years old.Results. In patients ≥65 years old IE was more often associated with previous medical care (odds ratio [OR]=14.9; 95% confidence interval [95%CI] 8.6;25.9), infections and tumors of the genitourinary system or tumors of the gastrointestinal tract (OR=12.6; 95%CI 6.4;24.6); there were more concomitant oncological diseases (OR=66.2; 95%CI 19.3;226.8), diabetes mellitus (OR=9.9; 95%CI 4.5;22.1), chronic kidney disease (OR=27.0; 95%CI 13.6;53.3). In patients ≥65 years old compared with non-drug users IE patients <65 years old (n=266), the incidence of enterococcal IE was higher (OR=3.3; 95%CI 1.4;7.9); the timing of IE diagnosis was longer – 60 (37;152) vs 30 (20;110) days (p<0.05); cardiac surgery was performed less often (8% vs 24.8%; p<0.05); in-hospital mortality was almost two-fold higher. However, with the exclusion from the mortality rate assessment of postmortem diagnosed IE cases in-hospital mortality in patients ≥65 years old and patients <65 years old did not differ significantly (14.8% vs 12.2% in non-drug users <65 years old and 14.9% in drug-users IE).Conclusion. Late diagnosis of IE and comorbidity, which limits the possibility of cardiac surgery, are the most important prognostic unfavorable features of IE in the elderly. |
| first_indexed | 2024-03-08T14:01:21Z |
| format | Article |
| id | doaj.art-b4cad2eb1d47440393291c1a2481cf2e |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2025-02-17T22:16:48Z |
| publishDate | 2020-05-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-b4cad2eb1d47440393291c1a2481cf2e2024-12-04T11:48:17ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532020-05-0116216617410.20996/1819-6446-2020-03-021715Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and OutcomesN. S. Chipigina0N. Yu. Karpova1D. A. Anichkov2T. B. Kondratieva3Pirogov Russian National Research Medical UniversityPirogov Russian National Research Medical UniversityPirogov Russian National Research Medical UniversityI.M. Sechenov First Moscow State Medical University (Sechenov University)In the context of the increased incidence of infectious endocarditis (IE) in the elderly, an assessment of clinical features of IE in elderly patients is still controversial.Aim. To study the clinical features and outcomes of IE in patients aged ≥65 years.Material and methods. А comparative assessment of risk factors, etiology, clinical manifestations, outcomes was performed in 75 IE patients ≥65 years old and in 356 IE patients <65 years old.Results. In patients ≥65 years old IE was more often associated with previous medical care (odds ratio [OR]=14.9; 95% confidence interval [95%CI] 8.6;25.9), infections and tumors of the genitourinary system or tumors of the gastrointestinal tract (OR=12.6; 95%CI 6.4;24.6); there were more concomitant oncological diseases (OR=66.2; 95%CI 19.3;226.8), diabetes mellitus (OR=9.9; 95%CI 4.5;22.1), chronic kidney disease (OR=27.0; 95%CI 13.6;53.3). In patients ≥65 years old compared with non-drug users IE patients <65 years old (n=266), the incidence of enterococcal IE was higher (OR=3.3; 95%CI 1.4;7.9); the timing of IE diagnosis was longer – 60 (37;152) vs 30 (20;110) days (p<0.05); cardiac surgery was performed less often (8% vs 24.8%; p<0.05); in-hospital mortality was almost two-fold higher. However, with the exclusion from the mortality rate assessment of postmortem diagnosed IE cases in-hospital mortality in patients ≥65 years old and patients <65 years old did not differ significantly (14.8% vs 12.2% in non-drug users <65 years old and 14.9% in drug-users IE).Conclusion. Late diagnosis of IE and comorbidity, which limits the possibility of cardiac surgery, are the most important prognostic unfavorable features of IE in the elderly.https://www.rpcardio.online/jour/article/view/2155infectious endocarditiselderlyetiologyclinicoutcome |
| spellingShingle | N. S. Chipigina N. Yu. Karpova D. A. Anichkov T. B. Kondratieva Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes Рациональная фармакотерапия в кардиологии infectious endocarditis elderly etiology clinic outcome |
| title | Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes |
| title_full | Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes |
| title_fullStr | Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes |
| title_full_unstemmed | Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes |
| title_short | Infectious Endocarditis in the Elderly – Comparative Study of Clinical Features, Course and Outcomes |
| title_sort | infectious endocarditis in the elderly comparative study of clinical features course and outcomes |
| topic | infectious endocarditis elderly etiology clinic outcome |
| url | https://www.rpcardio.online/jour/article/view/2155 |
| work_keys_str_mv | AT nschipigina infectiousendocarditisintheelderlycomparativestudyofclinicalfeaturescourseandoutcomes AT nyukarpova infectiousendocarditisintheelderlycomparativestudyofclinicalfeaturescourseandoutcomes AT daanichkov infectiousendocarditisintheelderlycomparativestudyofclinicalfeaturescourseandoutcomes AT tbkondratieva infectiousendocarditisintheelderlycomparativestudyofclinicalfeaturescourseandoutcomes |