Table 2. – Aspects of endocarditis in the elderly in a literature review, 2000-2020.
| Author | Country | N of study | Period | Age/ Sex | Affected valves | More frequent microorganisms | Underlying conditions | Complications | % of Surgeries | Mortality |
|---|---|---|---|---|---|---|---|---|---|---|
| Durante-Mangoni, 20084 | Several | 2,759 | 2000- 2005. | 1056 elderly (65 years and over) females: (35.8%) | Mi (50%) Ao (41%) Tri (7%) Intracardiac devices (10%); prostheses (26%) | S. aureus (28.3%) (MRSA 35.8%), bovis group (8.3%), Enterococci (16.5%) CoNS (14%); Viridans group streptococci (14.2%) | CABG (63%) AS (28%) invasive procedure (56.2%) DM (22.9%) and GUT (4.7%) and GIT CA (3.2%) | CHF (33,1%); CVA (146%); systemic embolism (15.3%); Abscess (14%); persistent Bacteremia (9.2%) | 38.9% | 24.9% |
| Remadi, 200917 | France | 348 | 1991 – 2006 | 75 elderly (75 years or older) M:47; F:28 | Mi: 45.3%; Ao: 54.7%; Mi-Ao: 16%; right-side IE: 16% valvar prosthesis (28%); Pacemaker (26.7%) | Streptococci (37.4%), staphylococci (36 %). CoNS (27.8%) in patients submitted to surgery. | DM 2 (25.3%); CKD (17.3%); Neoplasia (26.7%); | CHF (28%); embolism 18.7%; CNS major event 9,3%; Intracerebral Hemorrhage 1.3% Abscesses 18.7% | 29.3% | Overall: 16% Surgical: 9%; |
| Lopez, 201019 | Spain | 600 Left-side IE cases | 1996-2008 | Q3 (64-72 years): 152 and Q4 (>72 years): 148. | Nosocomial: 33%-37%; Prosthesis: 47%- 42%; Early prosthesis: 36%- 39%; Mi (nat): 51%-61% Mi (mech): 54%-35% Ao (nat): 49%-39% Ao (mech): 35%-21% Ao (bio): 12%-33% | CoNS: 22%-18%. S. aureus: 14%-14% MRSA: 18%-33%. Enterococci: 12%-13%; Viridans group: 12%-12% bovis group: 5%-7%. | Rheumatics: 11%-8%. Prostheses 45- 48%; Degeneration 12%-21%; DM: 28%- 29%. CA: 11%-13%. IV Catheter: 6%-12% Previous H. surgery: 14%- 12%. | CHF : 59-64% ; CVA: 18- 23% ; AKI: 40- 46%; Persistent Bacteremia: 32- 37%; Embolism: 24- 28%; Sepsis: 14%- 16%; Perivalvar abscess: 25- 26%. | 54%-40% | Overall: 37%-36%; Urg. S: 44%-39%; Elec S.: 28%-34%. D. Treatment: 40%-36% |
| Ramírez-Duque 201112 | Spain | 961 Left IE cases | 1984 –2008 | 65 years or older: 356 M: 63.3% | Nosocomial: 21.1%; native valve: 74,5%; Late prosthesis: 13.2%; Early prosthesis: 12.4% Ao: 50%; Mi: 37%; Mi-Ao: 11.4%; | Viridans group: 16.9%; S. aureus: 17.4%; MRSA 12.9%; CoNS: 17.1%; Enterococci: 16.3%; bovis group: 5.3%; GNB: 4.2%. | 80%. | CVA: 26.6%; Embolism: 29,2%; AKI: 39.6%; sepsis 16.5%; Intracardiac Complications: 27.8%; CHF: 28.9% | 36% | Overall: 43.2% |
| Bassetti, 20145 | Italy | 436 | 2004 –2011 | Group B: 65-74 years: 145 F: 30% Group C: 75 years or older: 137 F: 38.6% | Vegetation: 77.2%-78.1% | Enterococci: 11.7%-27%; Streptococci spp .: 33.1%-22.6%; Viridans group: 15.2%-7.3%; bovis group: 12.4%-11.2%; S. aureus: 14.5%-19.7%; CoNS: 11%-13.1%. | Valve disease: 47.6%-40.2%; Prosthesis: 40%-40.2% CHF: 30.3%-47.7%; CKD: 22.1%-29.2% DM2: 30.3%-23.4% CA: 23.5%-25.6% rheumatic carditis: 7.6%-2.9% | Embolism: 22.1%-13.9% Focal neurological sign11%-9.5%; Abscess: 15.9%-14.6% | 37.9%- 22.6% | Overall: 19.3%-22.6%. |
| Oliver, 20176 | France | 454 | 2008 –2013 | G2: 65-80 years: 173 M: 71.7% G3: age > 80 years: 51 M: 64.7% | Hosp.: 19.9%-23.5%; Post-op.: 11%-11.8%; Native valve: 57.8%-58.8%; Ao: G2: 42% Mi G3: 43.1%; Prosthetic valve: 42.2%-41.2%; Acute IE: 57.1%-68.8%; IE > 3 months: 14.3%-6.3%; Most common sites of entry (G3): GIT: 33.3%, GUT: 7.8%, skin (23.6%); | Enterococci: 15.6%-21.6% ; bovis group: 16.2% - 17.7%; viridans group: 17.9%-15.7%; CoNS 9,3%-5.9%; MSSA: 12.7%-11.8%; MRSA: 2.9%- 2% | Previous IE: 11%-11.8%; DM2: 19.1%-25.5%; SAH: 49.1%-58.8%; CAD: 17.8%-17%; CVA: 9.3%-7.8%; CKD: 14.5%-27.5%; CA: 24.3%-29.4% | Embolism in ATB: G3: 21.6%; AKI: G3:51%; Spondylitis: 12.6%-23.5% Abscess: 26.5%-29.4% | 69,6%-42,1% | In-hospital: 13.3%-15.7%; One-year: 19.7%-37.3%; Surgical: G3: 6,3% |
| Wu, 201911 | China | 405 | 2007 – 2016 | G3: 65 years or older: 59 M: 69.5% | Native: 83.1%; Mitral: 25.4%; Ao: 30.5%; Valves to the right: 6.8%; Prostheses: 13.6% Pacemaker: 3.4%; Community: 79.7%; Nosocomial: 10.2% | Streptococci: 22%; Viridans group: 5.1%; Staphylococci: 18.5%; S. aureus: 3.4%; CoNS: 15.3%; Enterococci: 1.7%. | Rheumatics: 18.6%; Previous Heart Surgery: 23.7%; Degenerative: 10.2%; COPD: 3.4%; CA: 3.4%; HD: 6.8%; SAH: 42.4%; DM: 16.9%; Bad oral hygiene: 49.2%. | CHF: 62.7%; Embolism: 39%; AKI: 30.5%; CVA: 23.7%; Arrythmia: 39% AF: 33.9%; Abscess: 13.6%; | Indication: 96.6% Surgery: 40.7% | In-hospital: 20.3% |
| Chun-Yu Lin, 202020 | Taiwan | 179 left IE cases | 2005 –2015 | 65 years or older: 38 F: 36.8% Mean age: 74.2±6.4 | Ao: 50% Exchange for: bio Ao: 100%; mech Ao: 0% Mi: 36.8 Exchange for: bio Mi: 100%; mech Mi: 0%. | Streptococci: 28.9%; Viridan s group: 13.2%; Enterococci: 10.5%; S. aureus: 7.9%. | SAH: 13.2%; DM: 28.9%; CKD: 10.5%; | MV: 23.7%; Inotropic drugs: 10.5%; Embolism: 23.7%; AKI: 5.3%; AF: 13.2%; CHF: 18.4%; Abscess: 2.6% | All patients underwent surgery, as the study evaluates patients undergoing it | In-hospital: 26.3% |
F: female; M: male; Mi: mitral; Ao: aortic; Tri: tricuspid; MRSA: methicillin-resistant Staphylococcus aureus; CoNS: Coagulase Negative Staphylococci; CABG: coronary artery bypass graft; AS: aortic stenosis; DM: diabetes mellitus; CA: cancer; GIT: gastrointestinal tract; CHF: congestive heart failure; CVA: cerebrovascular accident; IE: infective endocarditis; CKD: chronic kidney disease; CNS: central nervous system; (mech): mechanical; (nat): native; (bio): biological; AKI: acute kidney injury; Urg. S: urgent surgery; Elec. S: elective surgery; D. Treatment: Drug Treatment; GNB: Gram-Negative Bacilli; Valv. P.: Valve procedure; Hosp.: Hospital; Post-op.: Post-operative; GUT: genitourinary tract; SAH: systemic arterial hypertension; CAD: coronary artery disease; COPD: chronic obstructive pulmonary disease; MV: mechanical ventilation; AF: atrial fibrillation.