Age Determines Clinical Characteristics of Infective Endocarditis

09 nov 2008--Increasing age is a determinant of the clinical characteristics of infective endocarditis, according to an international prospective cohort study in Archives of Internal Medicine.
Researchers studied 2800 patients with infective endocarditis (1700 were under age 65, 1100 were 65 or older). Older patients were less likely to have vegetations and more likely to have abscesses than younger patients; they were also less likely to experience vascular manifestations of the disease, such as embolic events. Diabetes and cancers of the genitourinary or gastrointestinal tract were major predisposing factors in the older group.
After exclusion of patients with prosthetic- or healthcare-related endocarditis, mortality in older patients was still about twice that of younger patients.
The proportion of cases associated with healthcare procedures increased with age. Along with a high index of suspicion, the authors recommend appropriate antibiotic prophylaxis and greater adherence to aseptic practices when dealing with frail, older patients.
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Archives of Internal Medicine article (Free abstract; full text requires subscription)