Clinical and bacteriological characteristics of infective endocarditis in the elderly.
OBJECTIVE
To determine the clinical and bacteriological features of infective endocarditis in the elderly.


METHODS
Prospective case series.


METHODS
A university hospital that is both a referral and a primary care centre.


METHODS
114 consecutive patients treated for infective endocarditis from November 1990 to December 1993: 25 were > 70 years of age (group 1) and 89 were < 70 years old (group 2).


RESULTS
Location of infective endocarditis, clinical signs, and symptoms were similar in the two groups, except for a lower occurrence of embolic episodes in the elderly (group 1:8%, group 2: 28%; P < 0.04). A higher rate of infective endocarditis on intracardiac prosthetic devices was noted in group 1 (group 1: 52%, group 2: 25%; P < 0.05). The distribution of causative micro-organisms showed a higher proportion of bacteria from the gastrointestinal tract in the elderly (group D streptococci and enterococci: 48% in group 1 v 20% in group 2) and the presumed portal of entry was more often digestive (group 1: 50%, group 2: 17%; P = 0.01). Elderly patients were less often operated on (group 1: 24%, group 2: 43%; P = 0.07) and their mortality rate was higher (group 1: 28%, group 2: 13%; P = 0.08).


CONCLUSIONS
Infective endocarditis in patients over 70 often occurs in those with intracardiac prosthetic devices and is more often due to bacteria from the gastrointestinal tract. Its prognosis appears to be worse than in younger subjects.
Selton-Suty
C
C
Department of Cardiology, CHU Brabois, Nancy, France.
Hoen
B
B
Grentzinger
A
A
Houplon
P
P
Maignan
M
M
Juillière
Y
Y
Danchin
N
N
Canton
P
P
Cherrier
F
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011379:Prognosis; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications*