Article (Scientific journals)
Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry.
Pazdernik, Michal; Iung, Bernard; Mutlu, Bulent et al.
2022In Infection
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Keywords :
Elderly; Infective endocarditis; Prognosis; Propensity analysis; Surgery
Abstract :
[en] 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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Pazdernik, Michal ;  Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. ; Department of Cardiology, Second Medical School, Charles University, University
Iung, Bernard;  Cardiology Department, Bichat Hospital, APHP, Université de Paris, Paris, France.
Mutlu, Bulent;  Department of Cardiology, Marmara University Hospital, Pendik, Istanbul, Turkey.
Alla, François;  CHU de Bordeaux, Bordeaux, France.
Riezebos, Robert;  Heart Center, OLVG, Amsterdam, Netherlands.
Kong, William;  National University Heart Centre Singapore, Singapore, Singapore.
Nunes, Maria Carmo Pereira;  Federal University of Minas Gerais, Belo Horizonte, Brazil.
Pierard, Luc;  University Hospital Sart Tilman, University of Liege, Liege, Belgium.
Srdanovic, Ilija;  Medical Faculty University, Novi Sad, Serbia.
Yamada, Hirotsugu;  Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
De Martino, Andrea;  University Hospital of Pisa, Pisa, Italy.
Miglioranza, Marcelo Haertel;  Brasil Institute of Cardiology/University Foundation, Porto Alegre, Brazil.
Magne, Julien;  Cardiology Dept, CHU Limoges, INSERM 1094, University Hospital Dupuytren, 87042,
Piper, Cornelia;  Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum,
Laroche, Cécile;  EURObservational Research Programme, European Society of Cardiology, Biot,
Maggioni, Aldo P;  EURObservational Research Programme, European Society of Cardiology, Biot,  ; Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy.
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Habib, Gilbert;  Cardiology Dept, APHM, La Timone Hospital, Marseille, France. ; Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille,
Selton-Suty, Christine;  Cardiology Dept, CIC-ECCHU Nancy-Brabois, 54000, Nancy, France.  ; Association pour l'Etude et la Prevention de l'Endocardite Infectieuse (AEPEI),
EURO-ENDO Investigators, group
More authors (10 more) Less
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Avegliano, G
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Mahia, M
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Bangher, M
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Silva, C
Souza, A C
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de Mattos Barretto, R Bellio
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Abid, L
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Hlima, M Ben
Boudiche, S
Ouali, S
Zakhama, L
Filho, F Villaca
Antit, S
Slama, I
Gulel, O
Sahin, M
Sade, L E
Karacaglar, E
Kucukoglu, S
Cetinarslan, O
Yasar, U S
Canpolat, U
Braga, J
Mutlu, B
Atas, H
Dervishova, R
Ileri, C
Zaky, H
Alhashmi, J
Baslib, F
Tahir, J
Zarger, P
Woldman, S
Rodrigues, A
Menezes, L
Primus, C
Uppal, R
Bvekerwa, I
Chandrasekaran, B
Kopanska, A
Prendergast, B
Cannata, S
Chambers, J
Hancock, J
Silva, R
Klein, J
Rajani, R
Ursi, M P
Dworakowski, R
Fife, A
Breeze, J
Browne-Morgan, M
Gunning, M
Streather, S
Asch, F
Vilela, F
Zemedkun, M
Alyavi, B
Uzokov, J
Rodrigues, D
Silva, L
Morhy, S
Fischer, C
Silva, R
Vieira, M
Afonso, T
Abreu, J
Falcao, S N
Moises, V
More authors (883 more) Less
Language :
English
Title :
Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry.
Publication date :
15 March 2022
Journal title :
Infection
ISSN :
0300-8126
eISSN :
1439-0973
Publisher :
Urban und Vogel Medien und Medizin Verlagsgesellschaft mbH, United States - Delaware
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
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