Clinical Presentation and Risk Factors of Infective Endocarditis in the Elderly: A Systematic Review
Camelia Melania Budea, Felix Bratosin, Iulia Bogdan, Adrian Vasile Bota, Mirela Turaiche, Livius Ţîrnea, Carmen Nicoleta Stoica, A. Csep, Bogdan Feciche, S. Pescariu, Mălina Popa, Adelina Mavrea, Bogdan Andrei Bumbu, Satya Sai Sri Bandi, Iosif Marincu
Abstract
Infective endocarditis (IE) is a bacterial infection with high morbidity and mortality rates, particularly among the elderly. This systematic review was conducted to determine the clinical characteristics of IE in older adults and the risk factors that could lead to adverse outcomes. The research employed three databases (PubMed, Wiley, and Web of Science), with a primary search for studies that have described cases of IE in patients older than 65 years. From a total of 555 articles, 10 were selected for inclusion in the current study, comprising a total of 2222 patients with a confirmed diagnosis of IE. The primary findings were an increased incidence of staphylococcal and streptococcal infections (33.4% and32.0%, respectively), an increased prevalence of comorbidities, namely, cardiovascular disease, diabetes, and cancer, and a significantly greater mortality risk than the younger group. Regarding mortality risks, the pooled odds ratio for cardiac disorders was OR = 3.81, septic shock OR = 8.22, renal complications OR = 3.75, and advancing age OR = 3.54 were most frequently mentioned. Taking into consideration the fact that the majority of the elderly population suffers from significant complications and is unable to undergo surgery due to an increased risk of complications after the procedure, it is imperative that effective treatment methods should be investigated.