Journal article
Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry
Infection, Vol.50(5), pp.1191-1202
10/01/2022
DOI: 10.1007/s15010-022-01792-0
PMID: 35290614
Abstract
Purpose High mortality and a limited performance of valvular surgery are typical features of infective endocarditis (IE) in octogenarians, even though surgical treatment is a major determinant of a successful outcome in IE. Methods Data from the prospective multicentre ESC EORP EURO-ENDO registry were used to assess the prognostic role of valvular surgery depending on age. Results As compared to < 80 yo patients, >= 80 yo had lower rates of theoretical indication for valvular surgery (49.1% vs. 60.3%, p < 0.001), of surgery performed (37.0% vs. 75.5%, p < 0.001), and a higher in-hospital (25.9% vs. 15.8%, p < 0.001) and 1-year mortality (41.3% vs. 22.2%, p < 0.001). By multivariable analysis, age per se was not predictive of 1-year mortality, but lack of surgical procedures when indicated was strongly predictive (HR 2.98 [2.43-3.66]). By propensity analysis, 304 >= 80 yo were matched to 608 < 80 yo patients. Propensity analysis confirmed the lower rate of indication for valvular surgery (51.3% vs. 57.2%, p = 0.031) and of surgery performed (35.3% vs. 68.4%, p < 0.0001) in >= 80 yo. Overall mortality remained higher in >= 80 yo (in-hospital: HR 1.50[1.06-2.13], p = 0.0210; 1-yr: HR 1.58[1.21-2.05], p = 0.0006), but was not different from that of < 80 yo among those who had surgery (in-hospital: 19.7% vs. 20.0%, p = 0.4236; 1-year: 27.3% vs. 25.5%, p = 0.7176). Conclusion Although mortality rates are consistently higher in >= 80 yo patients than in < 80 yo patients in the general population, mortality of surgery in >= 80 yo is similar to < 80 yo after matching patients. These results confirm the importance of a better recognition of surgical indication and of an increased performance of surgery in >= 80 yo patients.
Details
- Title: Subtitle
- Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry
- Creators
- Michal Pazdernik - Institute of Clinical and Experimental MedicineBernard Iung - Université Paris CitéBulent Mutlu - Marmara UniversityFrancois Alla - Centre Hospitalier Universitaire de BordeauxRobert Riezebos - OLVGWilliam Kong - National University Heart Centre SingaporeMaria Carmo Pereira Nunes - Univ Fed Minas Gerais, Belo Horizonte, MG, BrazilLuc Pierard - University of LiègeIlija Srdanovic - University of Novi SadHirotsugu Yamada - Tokushima UniversityAndrea De Martino - Azienda Ospedaliera Universitaria PisanaMarcelo Haertel Miglioranza - Univ Fdn, Brasil Inst Cardiol, Porto Alegre, RS, BrazilJulien Magne - Hôpital Universitaire DupuytrenCornelia Piper - Ruhr University BochumCecile Laroche - European Society of CardiologyAldo P. Maggioni - European Society of CardiologyPatrizio Lancellotti - Centre Hospitalier Universitaire de LiègeGilbert Habib - Hôpital de la TimoneChristine Selton-Suty - Association Française pour le Dépistage et la Prévention des Handicaps de l’EnfantEuropean Endocarditis (EURO-ENDO) Investigators GroupYehia Saleh (Contributor) - Internal Medicine
- Resource Type
- Journal article
- Publication Details
- Infection, Vol.50(5), pp.1191-1202
- DOI
- 10.1007/s15010-022-01792-0
- PMID
- 35290614
- NLM abbreviation
- Infection
- ISSN
- 0300-8126
- eISSN
- 1439-0973
- Publisher
- Springer Nature
- Number of pages
- 12
- Grant note
- AstraZeneca Bristol Myers Squibb; Bristol-Myers Squibb Menarini Int. Op.; Menarini Group Abbott Vascular Int.; Abbott Laboratories Alliance Daiichi Sankyo Europe GmbH Eli Lilly and Company; Eli Lilly SERVIER; Servier Pfizer Alliance Novartis Pharma AG Amgen Cardiovascular
- Language
- English
- Date published
- 10/01/2022
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755388702771
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