Comparison of the clinical manifestations of infective endocarditis between elderly and young patients - a 3-year study.
OBJECTIVE
Infective endocarditis (IE) is associated with high morbidity and mortality. This study investigated the clinical manifestations and outcomes of IE and compared them between old and young patients.


METHODS
In this retrospective study, data for patients with IE who were treated from November 1, 2003 to October 30, 2006 were collected. Patients were identified as having IE if they met the modified Duke criteria for definitive IE.


RESULTS
Seventy two patients were included. The most common symptoms were fever (81%) and dyspnea (50%). Fifty four patients (75%) had culture-positive IE. Staphylococcus aureus (35%) was the most common organism isolated, followed by Streptococcus spp. (26%). Vegetations were detected in 60 patients (83%): mitral valve (MV; 40%), aortic valve (AV; 24%), tricuspid valve (TV; 14%), MV and AV (4%), and pulmonary valve (1%). Thirty nine patients (54%) had embolic complications - 26 older patients (79%) and 13 younger patients (33%). Twenty two patients (31%) died in hospital. There were significant differences in clinical features between older and younger patients. Diabetes mellitus (p <or= 0.01), MV vegetation (p <or= 0.01), emboli (p <or= 0.01), and mortality (p = 0.01) were more common among older patients, while male sex (p <or= 0.01), intravenous drug use (p <or= 0.01), S. aureus endocarditis (p <or= 0.01), and TV vegetation (p = 0.01) were more common in younger patients.


CONCLUSIONS
While this study showed significant differences between older and younger patients, further investigation will be necessary to more precisely characterize the clinical spectrum of IE.
Huang
Tseng-Yu
TY
Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Tseng
Hsiang-Kuang
HK
Liu
Chang-Pan
CP
Lee
Chun-Ming
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004617:Embolism / Q000209:etiology; D004696:Endocarditis / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006351:Heart Valves / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D013291:Streptococcus / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult