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Research article
Yonghong xiao
Zhejiang University First Affiliated Hospital State Key Laboratory for Diagnosis and Treatment of Infectious Diseases
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Infective endocarditis (IE) is a serious disease, with a worse prognosis in the elderly. Aims To explore the clinical features and prognosis of old patients with IE in a tertiary hospital. Methods A retrospective cohort study was conducted. A total of 407 patients diagnosed as IE were divided into two groups: 348 patients under 65 years old and 59 patients over 65 years old. Results For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as in younger patients. Comorbidities like hypertension (P＜0.001) and diabetes (P=0.023) were more common in older patients. Complications like renal insufficiency (P=0.027) and arrhythmia (P＜0.001) were also more common in older patients. The old patients had a lower operation rate (40.7% vs 60.6%, P=0.004) and higher in-hospital mortality (20.3% vs 8.9%, P=0.008) compared with the younger patients. Pitt score ≥4 (P=0.043, OR=28.0, 95% CI 1.1-700.4) and renal insufficiency (P=0.011, OR=34.2, 95% CI 2.2-521.2) were independent risk factors of in-hospital mortality for older patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR = 1.722, 95% CI 0.563-5.365, P = 0.005).The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P=0.007). Conclusions IE in older patients present with more comorbidities and complications as well as a higher mortality than younger patients. Surgery were underused in old patients and old patients with surgical treatment had better long-term prognosis.
Keywords
Infective endocarditis; elderly; risk factors; surgery
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
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Submission checks complete
On 06 Nov, 2019
Editorial decision: Accept
On 08 Oct, 2019
Editor assigned
On 08 Oct, 2019
Editor invited
On 07 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 01 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 27 Sep, 2019
Review #1 received
Received 26 Sep, 2019
Review #2 received
Received 23 Sep, 2019
Reviewer #2 agreed
On 16 Sep, 2019
Reviewer #1 agreed
On 13 Sep, 2019
Reviewers invited
Invitations sent on 11 Sep, 2019
Editor assigned
On 10 Sep, 2019
Submission checks complete
On 09 Sep, 2019
Editor invited
On 09 Sep, 2019
Version 1
Posted 19 Jul, 2019
No comments provided
Editorial decision: Major revision
On 13 Aug, 2019
Review #2 received
Received 06 Aug, 2019
Review #1 received
Received 27 Jul, 2019
Reviewer #2 agreed
On 19 Jul, 2019
Reviewer #1 agreed
On 17 Jul, 2019
Reviewers invited
Invitations sent on 16 Jul, 2019
Submission checks complete
On 15 Jul, 2019
Editor invited
On 15 Jul, 2019
Editor assigned
On 15 Jul, 2019
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Subject Areas
Infectious Diseases
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A new preprint design is coming!
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yonghong xiao
Zhejiang University First Affiliated Hospital State Key Laboratory for Diagnosis and Treatment of Infectious Diseases
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 06 Nov, 2019
Editorial decision: Accept
On 08 Oct, 2019
Editor assigned
On 08 Oct, 2019
Editor invited
On 07 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 01 Oct, 2019
No comments provided
Editorial decision: Minor revision
On 27 Sep, 2019
Review #1 received
Received 26 Sep, 2019
Review #2 received
Received 23 Sep, 2019
Reviewer #2 agreed
On 16 Sep, 2019
Reviewer #1 agreed
On 13 Sep, 2019
Reviewers invited
Invitations sent on 11 Sep, 2019
Editor assigned
On 10 Sep, 2019
Submission checks complete
On 09 Sep, 2019
Editor invited
On 09 Sep, 2019
Version 1
Posted 19 Jul, 2019
No comments provided
Editorial decision: Major revision
On 13 Aug, 2019
Review #2 received
Received 06 Aug, 2019
Review #1 received
Received 27 Jul, 2019
Reviewer #2 agreed
On 19 Jul, 2019
Reviewer #1 agreed
On 17 Jul, 2019
Reviewers invited
Invitations sent on 16 Jul, 2019
Submission checks complete
On 15 Jul, 2019
Editor invited
On 15 Jul, 2019
Editor assigned
On 15 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background Infective endocarditis (IE) is a serious disease, with a worse prognosis in the elderly. Aims To explore the clinical features and prognosis of old patients with IE in a tertiary hospital. Methods A retrospective cohort study was conducted. A total of 407 patients diagnosed as IE were divided into two groups: 348 patients under 65 years old and 59 patients over 65 years old. Results For older patients, clinical symptoms such as fever, anemia, and heart murmur were as common as in younger patients. Comorbidities like hypertension (P＜0.001) and diabetes (P=0.023) were more common in older patients. Complications like renal insufficiency (P=0.027) and arrhythmia (P＜0.001) were also more common in older patients. The old patients had a lower operation rate (40.7% vs 60.6%, P=0.004) and higher in-hospital mortality (20.3% vs 8.9%, P=0.008) compared with the younger patients. Pitt score ≥4 (P=0.043, OR=28.0, 95% CI 1.1-700.4) and renal insufficiency (P=0.011, OR=34.2, 95% CI 2.2-521.2) were independent risk factors of in-hospital mortality for older patients. Surgical treatment was a significant predictor of one-year mortality even after adjusting for the confounders (HR = 1.722, 95% CI 0.563-5.365, P = 0.005).The one-year survival rate was higher for older patients with surgical intervention than those without (95.8% vs 68.6%, P=0.007). Conclusions IE in older patients present with more comorbidities and complications as well as a higher mortality than younger patients. Surgery were underused in old patients and old patients with surgical treatment had better long-term prognosis.
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