Age-dependent profile of left-sided infective endocarditis: a 3-center experience.
BACKGROUND
The influence of age on the main epidemiological, clinical, echocardiographic, microbiological, and prognostic features of patients with infective endocarditis remains unknown. We present the series with the largest numbers and range of ages of subjects to date that analyzes the influence of age on the main characteristics of patients with isolated left-sided infective endocarditis. Furthermore, this series is the first one in which patients have been distributed according to age quartile.


RESULTS
A total of 600 episodes of left-sided endocarditis consecutively diagnosed in 3 tertiary centers were stratified into age-specific quartiles and 107 variables compared between the different groups. With increasing age, the percentage of women, previous heart disease, predisposing disease (diabetes mellitus and cancer), and infection by enterococci and Streptococcus bovis also increased. Valvular insufficiency and perforation and Staphylococcus aureus infection were more common in younger patients. The therapeutic approach differed depending on patient age because of the growing proportion of older patients who only received medical treatment. Clinical course and hospital prognosis were worse in the older patients because of increased surgical mortality among them.


CONCLUSIONS
Increasing age is associated with less valvular impairment (insufficiency and perforation), a more favorable microbiological profile, and increased surgical mortality among adults with left-sided infective endocarditis.
Instituto de Ciencias del Corazón, Hospital Clínico Universitario, Valladolid, Spain. javihouston@yahoo.es
Javier
J
López
Ana
A
Revilla
Isidre
I
Vilacosta
Teresa
T
Sevilla
Eduardo
E
Villacorta
Cristina
C
Sarriá
Eduardo
E
Pozo
María Jesús
MJ
Rollán
Itziar
I
Gómez
Pedro
P
Mota
José Alberto
JA
San Román
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004562:Electrocardiography; D004696:Endocarditis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult