Comprehensive geriatric assessment in older patients suffering from infective endocarditis. A prospective multicentric cohort study

Forestier, E.; Roubaud-Baudron, C.; Fraisse, T.; Patry, Claire; Gavazzi, G.; Hoën, Bruno; Carauz-Paz, P.; Moheb-Khosravi, B.; Delahaye, François; Sost, G.; Pocard, Marc; Nazeyrollas, Pierre; Strady, C.; Alla, François; Selton‐Suty, Christine; Schambach, S.; Vallette, d’O.; Khosravi, Bardia; Roubaud, Claire; Lafargue, A.; Guerville, Florent; Kobeh, D.; Averty, E.; Thiennaud, L.; Soulas, E.; Basileu, Tatiana; Chuzeville, Michel; Laurain, MC; Novella, Jean‐Luc; Bertholon, Laurie-Anne; Jaïdi, Yacine; Guiard, R.; Naturel, J.; Vitrat, Virginie; Duval, Xavier; Wirth, G.; Pavèse, Patricia; Isabelle, Pierre; Fernandes, Elisabeth; Curlier, Elodie; Boibieux, A.; Goehringer, François; Béraud, Guillaume; Nguyen, Yohan; Tattevin, Pierre; Revest, Matthieu; Piau, Caroline; Paz, P.C.; Vancon, Antoine; Naem, N.; Richard, Benjamin; Iung, Bernard; Dijos, Marina; Fluttaz, Arnaud; Ennezat, Pierre-Vladimir; Beaufort, Corinne; Torossian, F; Brasselet, Camille; Donal, Erwan; Pineau, O.; Agrinier, Nelly; Erpelding, Marie-Line; Sime, Willy Ngueyon; Clavere, Gaëlle; Lebouc, M.; Ilic-Habensus, Emila; Durrieu, J.; Habet, T.; Dupré, Christelle; Chaissac, A.-M.; Touati, Selim; Delahaye, A; Marquis, Eric; Warchol, Marie; Thébault, Elise; Jouan, Caroline; Campagnac, Catherine; Petitgenêt, I.

doi:10.1016/j.cmi.2019.04.021

Cited by 27 publications

(32 citation statements)

References 29 publications

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“…Our findings are based on data from an unselected patient cohort and provide novel results on a patient population sparsely described. A study from 14 French hospitals included 120 patients with IE ≥75 years and identified that 15.8% underwent valvular surgery [31]. A Spanish study from four tertiary centers identified that 17.6% (N = 6) of octogenarian patients underwent surgery.…”

Section: Proportion Of Patients With Ie Undergoing Surgerymentioning

confidence: 99%

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

et al. 2020

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Background Infective endocarditis (IE) is associated with high mortality. Surgery may improve survival and reduce complications, but the balance between benefit and harm is difficult and may be closely related to age and type of surgical intervention. We aimed to examine how age and type of left-sided surgical intervention modified mortality in patients undergoing surgery for IE. Methods By crosslinking nationwide Danish registries we identified patients with first-time IE undergoing surgical treatment 2000–2017. Patients were grouped by age < 60 years, 60–75 years, and ≥ 75 years. Multivariable adjusted Cox proportional hazard analysis was used to examine factors associated with 90-day mortality. Results We included 1767 patients with IE undergoing surgery, 735 patients < 60 years (24.1% female), 766 patients 60–75 years (25.8% female), and 266 patients ≥75 years (36.1% female). The proportions of patients undergoing surgery were 35.3, 26.9, and 9.1% for patients < 60 years, 60–75 years, and > 75 years, respectively. Mortality at 90 days were 7.5, 13.9, and 22.3% (p < 0.001) for three age groups. In adjusted analyses, patients 60–75 years and patients ≥75 years were associated with a higher mortality, HR = 1.84 (95% CI: 1.48–2.29) and HR = 2.47 (95% CI: 1.88–3.24) as compared with patients < 60 years. Factors associated with 90-day mortality were: mitral valve surgery, a combination of mitral and aortic valve surgery as compared with isolated aortic valve surgery, age, diabetes, and prosthetic heart valve implantation prior to IE admission. Conclusions In patients undergoing surgery for IE, mortality increased significantly with age and 1 in 5 died above age 75 years. Mitral valve surgery as well as multiple valve interventions augmented mortality further.

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Section: Proportion Of Patients With Ie Undergoing Surgerymentioning

confidence: 99%

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

et al. 2020

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“…Another limitation was that unlike some other large databases, NIS can account for race but not ethnicity. Also, NIS cannot precisely account for patients' current functional, nutritional or cognitive characteristics, as these were recently shown to be key prognostic parameters of IE in elderly patients [21].…”

Section: Discussionmentioning

confidence: 99%

The influence of race in older adults with infective endocarditis

et al. 2020

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Background: Age is a risk factor for infective endocarditis, and almost half of diagnosed patients are age ≥ 60 years. Large national studies have not evaluated inpatient mortality and surgical valvular interventions between older White and Black patients hospitalized with infective endocarditis. Methods: We used the Nationwide Inpatient Sample database to identify older adults ≥60 years in North America with a principle diagnosis of infective endocarditis. Multivariate logistic regression was used to compare in-hospital mortality and valvular repairs/replacement between older Black and White patients. Results: Of 10,390 adults, age ≥ 60 years hospitalized for infective endocarditis during 2013 and 2014, 7356 were White and 1089 Black. Blacks were younger (mean age: 70.5 ± 0.5 vs. 73.5 ± 0.2 years, p < 0.01), lived in more zip codes with a median annual income <$39,000/yr. (40.4% vs 18.8%, p < 0.01), and had higher co-morbidity burden (Charlson comorbidity score ≥ 3: 54.6% vs 40.7%, p < 0.01). After multivariate adjustment, Blacks had higher odds for in-hospital mortality (Odds Ratio (OR) = 2.0, [Confidence Interval (CI) 1.1-3.8]; p = 0.020), and lower odds for mitral valve repairs/replacements (OR = 0.53, CI: 0.29-0.99, p = 0.049). Conclusions: Blacks age ≥ 60 years hospitalized in North America with infective endocarditis are less likely to undergo mitral valvular repairs/replacement and had higher in-hospital mortality compared to White patients.

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“…4 Forestier et al determined that elderly patients with IE have an increased likelihood for developing malnutrition, leading to overall greater mortality. 5 However, the study evaluated only elderly patients (mean age: 83 years) who were followed during and after hospitalizations. Because of the high prevalence of malnutrition in hospitals, it is likely to affect a broader age range of patients with IE.…”

Section: Introductionmentioning

confidence: 99%

“…Malnutrition impacts over 30% of hospitalized patients 1‐3 but is often underrecognized in acute care settings 4 . Forestier et al determined that elderly patients with IE have an increased likelihood for developing malnutrition, leading to overall greater mortality 5 . However, the study evaluated only elderly patients (mean age: 83 years) who were followed during and after hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Impact of Malnutrition in Patients With Infective Endocarditis

2020

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Background: Effects of malnutrition on patients with infective endocarditis (IE) have not been fully studied. Because malnutrition is associated with poor health, we hypothesized that among patients with IE, those with malnutrition would have more negative in-hospital outcomes. Methods: The National Inpatient Sample was used to identify adults ≥18 years old with IE. We compared outcomes of in-hospital mortality, morbidity, valvular interventions, and utilization of resources between individuals with and without malnutrition. Results: 11,939 adults ≥18 years were hospitalized with IE, 2035 had a secondary diagnosis for malnutrition. There were no significant differences in age (mean age ± SEM: 55.6 ± 1.0 vs 54.3 ± 0.4 years, P = .

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Comprehensive geriatric assessment in older patients suffering from infective endocarditis. A prospective multicentric cohort study

Cited by 27 publications

References 29 publications

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

The influence of race in older adults with infective endocarditis

Impact of Malnutrition in Patients With Infective Endocarditis

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