Better prognosis of elderly patients with infectious endocarditis in the era of routine echocardiography and nonrestrictive indications for valve surgery.
OBJECTIVE
It has been reported that endocarditis in the elderly may have a poor outcome. Our aim was to assess the different features and prognosis, if any, in the present time.


METHODS
Of 103 patients with proven endocarditis, 31 were 65 years or older and 72 were younger than 65 years. Degenerative heart disease was seen more frequently in the elderly (22.5% vs 2.7%, P =.003). Drug abuse and immunodeficiency virus infection were more common in the younger group, as was tricuspid endocarditis (26.3% vs 0%, P <.001). At clinical presentation cardiac failure (41.9 vs 19.4%, P =.02) and leukocytosis (61.2% vs 40.2%, P =.049) were seen more frequently in the elderly.


RESULTS
Despite other similar clinical features, it took longer to diagnose older patients (7.2 +/- 6.2 vs 3.2 +/- 3.5 days, P <.001). Enterococcus infected the aged more often (32.2% vs 13.1%, P =.001). During hospitalization, heart failure and embolization tended to be more common in the elderly and the younger group, respectively. There were no significant differences in the incidence of anatomic complications, the need for operation, and overall mortality.


CONCLUSIONS
Although a worse prognosis has been reported in elderly patients with infective endocarditis, the early use of transesophageal echocardiographic examinations and equal therapeutic options provides a similar outcome when compared with younger subjects.
Zamorano
José
J
Echocardiography Laboratory of the Hospital Clínico San Carlos, Madrid, Spain. jlzamorano@jet.es
Sanz
Javier
J
Moreno
Raúl
R
Almería
Carlos
C
Rodrigo
José Luis
JL
de Marco
Ester
E
Serra
Viviana
V
Samedi
Miriam
M
Sánchez-Harguindey
Luis
L
D000368:Aged; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis