Infective Endocarditis in the Elderly: Diagnostic and Treatment Options

Ursi, Maria Paola; Durante‐Mangoni, Emanuele; Rajani, Ronak; Hancock, Jane; Chambers, John; Prendergast, Bernard

doi:10.1007/s40266-018-0614-7

Cited by 23 publications

(37 citation statements)

References 55 publications

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“…The incidence of IE is increasing with age and predominant in male, as previously described [21]. For example, in people aged from 80 to 89 years, incidence of IE was 500 per million inhabitants in males vs. 250 per million inhabitants in females [2,22]. This higher incidence could be explained by the higher prevalence of valvular diseases and valvular prostheses in elderly and males, along with other comorbidities known to promote bacterial infections, and decreased immunity with ageing [23–26].…”

Section: Discussionmentioning

confidence: 82%

Incidence, characteristics, and mortality of infective endocarditis in France in 2011

et al. 2019

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ObjectivesWe assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011.MethodsIE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality.ResultsThe analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE.ConclusionWe reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality.

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Section: Discussionmentioning

confidence: 82%

Incidence, characteristics, and mortality of infective endocarditis in France in 2011

et al. 2019

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“…Microrganismos mais prevalentes foram enterococos 18 (25,7%). Entre 12 S. aureus isolados,10 (83,3%) eram MRSA e, desses, 6 eram hospitalares e 4 comunitários. Hemoculturas foram negativas em 27,8% (Figura 1).…”

Section: Resultsunclassified

“…A endocardite infecciosa (EI) é uma doença grave, com mortalidade intra-hospitalar média de 20%. [1][2][3] Apresenta incidência crescente, com destaque para o aumento de sua prevalência na população idosa. [4][5][6][7][8][9] Em pacientes da terceira idade com EI, existem diferenças quanto a apresentação clínica, complicações, presença de comorbidades, abordagem terapêutica e mortalidade.…”

Section: Introductionunclassified

“…Encontram-se comorbidades em mais da metade de idosos, com consequente necessidade de cuidados prolongados de profissionais da saúde, o que aumenta a probabilidade de aquisição da EI. 3,16 O diagnóstico de EI em idosos, frequentemente, é atrasado ou esquecido. 3 As manifestações podem ser inespecíficas, atribuídas ao envelhecimento e outras condições.…”

Section: Introductionunclassified

“…3,16 O diagnóstico de EI em idosos, frequentemente, é atrasado ou esquecido. 3 As manifestações podem ser inespecíficas, atribuídas ao envelhecimento e outras condições. A febre pode estar ausente, havendo apenas confusão mental.…”

Section: Introductionunclassified

See 2 more Smart Citations

Endocardite Infecciosa em Idosos: Características Distintas

Lemos

Silva

Correa

et al. 2021

Arquivos Brasileiros De Cardiologia

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A comparison of different antibiotic regimens for the treatment of infective endocarditis

Martí‐Carvajal

Dayer

Conterno

et al. 2020

Cochrane Database of Systematic Reviews

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BackgroundInfective endocarditis is a microbial infection of the endocardial surface of the heart. Antibiotics are the cornerstone of treatment, but due to the di erences in presentation, populations a ected, and the wide variety of micro-organisms that can be responsible, their use is not standardised. This is an update of a review previously published in 2016. ObjectivesTo assess the existing evidence about the clinical benefits and harms of di erent antibiotics regimens used to treat people with infective endocarditis. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase Classic and Embase, LILACS, CINAHL, and the Conference Proceedings Citation Index -Science on 6 January 2020. We also searched three trials registers and handsearched the reference lists of included papers. We applied no language restrictions. Selection criteriaWe included randomised controlled trials (RCTs) assessing the e ects of antibiotic regimens for treating definitive infective endocarditis diagnosed according to modified Duke's criteria. We considered all-cause mortality, cure rates, and adverse events as the primary outcomes. We excluded people with possible infective endocarditis and pregnant women. Data collection and analysisTwo review authors independently performed study selection, 'Risk of bias' assessment, and data extraction in duplicate. We constructed 'Summary of findings' tables and used GRADE methodology to assess the quality of the evidence. We described the included studies narratively.A comparison of di erent antibiotic regimens for the treatment of infective endocarditis (Review)

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Infective Endocarditis in the Elderly: Diagnostic and Treatment Options

Cited by 23 publications

References 55 publications

Incidence, characteristics, and mortality of infective endocarditis in France in 2011

Incidence, characteristics, and mortality of infective endocarditis in France in 2011

Endocardite Infecciosa em Idosos: Características Distintas

A comparison of different antibiotic regimens for the treatment of infective endocarditis

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