TY - JOUR
T1 - Role of age and comorbidities in mortality of patients with infective endocarditis
AU - Armiñanzas, Carlos
AU - Fariñas-Alvarez, Concepción
AU - Zarauza, Jesús
AU - Muñoz, Patricia
AU - González Ramallo, Víctor
AU - Martínez Sellés, Manuel
AU - Miró Meda, José Mª
AU - Pericás, Juan Manuel
AU - Goenaga, Miguel Ángel
AU - Ojeda Burgos, Guillermo
AU - Rodríguez Álvarez, Regino
AU - Castelo Corral, Laura
AU - Gálvez-Acebal, Juan
AU - Martínez Marcos, Francisco Javier
AU - Fariñas, Maria Carmen
AU - Fernández Sánchez, Fernando
AU - Noureddine, Mariam
AU - Rosas, Gabriel
AU - de la Torre Lima, Javier
AU - Aramendi, José
AU - Bereciartua, Elena
AU - Blanco, María José
AU - Blanco, Roberto
AU - Boado, María Victoria
AU - Campaña Lázaro, Marta
AU - Crespo, Alejandro
AU - Goikoetxea, Josune
AU - Iruretagoyena, José Ramón
AU - Irurzun Zuazabal, Josu
AU - López-Soria, Leire
AU - Montejo, Miguel
AU - Nieto, Javier
AU - Rodrigo, David
AU - Rodríguez, David
AU - Rodríguez, Regino
AU - Vitoria, Yolanda
AU - Voces, Roberto
AU - García López, Mª Victoria
AU - Georgieva, Radka Ivanova
AU - Ojeda, Guillermo
AU - Rodríguez Bailón, Isabel
AU - Ruiz Morales, Josefa
AU - Cuende, Ana María
AU - Echeverría, Tomás
AU - Fuerte, Ana
AU - Gaminde, Eduardo
AU - Goenaga, Miguel Ángel
AU - Idígoras, Pedro
AU - Iribarren, José Antonio
AU - de Benito, Natividad
N1 - Copyright © 2019. Published by Elsevier B.V.
PY - 2019/6
Y1 - 2019/6
N2 - PURPOSE: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.METHODS: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.RESULTS: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32-3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39-1.88),and non-performed surgery (HR:1.64;95% CI:11.16-1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality.CONCLUSION: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group.
AB - PURPOSE: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.METHODS: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.RESULTS: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32-3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39-1.88),and non-performed surgery (HR:1.64;95% CI:11.16-1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality.CONCLUSION: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group.
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Area Under Curve
KW - Comorbidity
KW - Databases, Factual
KW - Endocarditis/etiology
KW - Female
KW - Heart Failure/mortality
KW - Hospital Mortality
KW - Humans
KW - Male
KW - Middle Aged
KW - Proportional Hazards Models
KW - Prospective Studies
KW - ROC Curve
KW - Risk Factors
KW - Spain/epidemiology
KW - Staphylococcal Infections/mortality
U2 - 10.1016/j.ejim.2019.03.006
DO - 10.1016/j.ejim.2019.03.006
M3 - Article
C2 - 30904433
VL - 64
SP - 63
EP - 71
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
ER -