[Bacterial endocarditis in patients over 60 years of age].
Bacterial endocarditis (BE) is a disease difficult to diagnose and with poor prognosis in older people. A total of 76 episodes of this disease occurring in 73 patients were studied with particular attention to clinical manifestation, underlying heart disease, etiological germs, hospitalary mortality and prognosis within 6 months from diagnosis. All patients were 60 years old or older. Mean age was 72 +/- 7 years and male/female relation 1.7/1 Fever and heart murmur were present in 93% and 89% of patients, respectively; 33% of patients complained of vertebral or paravertebral pain which can be an early symptom of this disease. BE was suspected in 47% of patients at admission. Hospitalary mortality was 33% and increased to 47% within 6 months. The mean age of survivors was 71.7 +/- 7 years, versus 73.9 +/- 6 in the deceased (p = 0.08). Lack of suspicion of BE at admission was related with increased mortality (p = 0.04). The germ more frequently isolated was Streptococcus (73%). 53% of patients had some underlying heart disease. Aortic valve was involved in 50% and mitral valve in 21% of the cases. Of all the patients that in retrospect would have had indication of surgery (n = 25) 9 patients were operated, 6 during the first admission with a mortality of 17%. In those patients who were not operated, the mortality was 100% (16/16), making this difference statistically significant, p less than 0.001.
Servicio de Clínica Médica, Hospital Privado de Comunidad, Mar del Plata, Argentina.
L M
LM
De Wouters
R
R
Furnari
F
F
Pandullo
M J
MJ
Maxit
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011379:Prognosis; D012737:Sex Factors
Endocarditis bacteriana en pacientes mayores de 60 años.