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Armiñanzas C, Fariñas-Alvarez C, Zarauza J, Muñoz P, González Ramallo V, Martínez Sellés M, Miró Meda JM, Pericás JM, Goenaga MÁ, Ojeda Burgos G, Rodríguez Álvarez R, Castelo Corral L, Gálvez-Acebal J, Martínez Marcos FJ, Fariñas MC, Fernández Sánchez F, Noureddine M, Rosas G, de la Torre Lima J, Aramendi J, Bereciartua E, Blanco MJ, Blanco R, Boado MV, Campaña Lázaro M, Crespo A, Goikoetxea J, Iruretagoyena JR, Irurzun Zuazabal J, López-Soria L, Montejo M, Nieto J, Rodrigo D, Rodríguez D, Rodríguez R, Vitoria Y, Voces R, García López MV, Georgieva RI, Ojeda G, Rodríguez Bailón I, Ruiz Morales J, Cuende AM, Echeverría T, Fuerte A, Gaminde E, Goenaga MÁ, Idígoras P, Iribarren JA, Izaguirre Yarza A, Kortajarena Urkola X, Reviejo C, Carrasco R, Climent V, Llamas P, Merino E, Plazas J, Reus S, Álvarez N, Bravo-Ferrer JM, Castelo L, Cuenca J, Llinares P, Miguez Rey E, Rodríguez Mayo M, Sánchez E, Sousa Regueiro D, Martínez FJ, Alonso MDM, Castro B, García Rosado D, Durán MDC, Miguel Gómez MA, Lacalzada J, Nassar I, Plata Ciezar A, Reguera Iglesias JM, Asensi Álvarez V, Costas C, de la Hera J, Fernández Suárez J, Iglesias Fraile L, León Arguero V, López Menéndez J, Mencia Bajo P, Morales C, Moreno Torrico A, Palomo C, Paya Martínez B, Rodríguez Esteban Á, Rodríguez García R, Telenti Asensio M, Almela M, Ambrosioni J, Azqueta M, Brunet M, Bodro M, Cartañá R, Falces C, Fita G, Fuster D, García de la Mària C, Hernández-Meneses M, Llopis Pérez J, Marco F, Miró JM, Moreno A, Nicolás D, Ninot S, Quintana E, Paré C, Pereda D, Pericás JM, Pomar JL, Ramírez J, Rovira I, Sandoval E, Sitges M, Soy D, Téllez A, Tolosana JM, Vidal B, Vila J, Adán I, Bermejo J, Bouza E, Celemín D, Cuerpo Caballero G, Delgado Montero A, Fernández Cruz A, García Mansilla A, García Leoni ME, González Ramallo V, Kestler Hernández M, Hualde AM, Marín M, Martínez-Sellés M, Menárguez MC, Muñoz P, Rincón C, Rodríguez-Abella H, Rodríguez-Créixems M, Pinilla B, Pinto Á, Valerio M, Vázquez P, Verde Moreno E, Antorrena I, Loeches B, Martín Quirós A, Moreno M, Ramírez U, Rial Bastón V, Romero M, Saldaña A, Agüero Balbín J, Amado C, Armiñanzas Castillo C, Arnaiz García A, Cobo Belaustegui M, Fariñas MC, Fariñas-Álvarez C, Gómez Izquierdo R, García I, González-Rico C, Gutiérrez-Cuadra M, Gutiérrez Díez J, Pajarón M, Parra JA, Sarralde A, Teira R, Zarauza J, Domínguez F, García Pavía P, González J, Orden B, Ramos A, Centella T, Hermida JM, Moya JL, Martín-Dávila P, Navas E, Oliva E, Del Río A, Ruiz S, Hidalgo Tenorio C, Almendro Delia M, Araji O, Barquero JM, Calvo Jambrina R, de Cueto M, Gálvez Acebal J, Méndez I, Morales I, López-Cortés LE, de Alarcón A, García E, Haro JL, Lepe JA, López F, Luque R, Alonso LJ, Azcárate P, Azcona Gutiérrez JM, Blanco JR, García-Álvarez L, Oteo JA, Sanz M, de Benito N, Gurguí M, Pacho C, Pericas R, Pons G, Álvarez M, Fernández AL, Martínez A, Prieto A, Regueiro B, Tijeira E, Vega M, Canut Blasco A, Cordo Mollar J, Gainzarain Arana JC, García Uriarte O, Martín López A, Ortiz de Zárate Z, Urturi Matos JA, García Domínguez G, Sánchez-Porto A, Arribas Leal JM, García Vázquez E, Hernández Torres A, Blázquez A, de la Morena Valenzuela G, Alonso Á, Aramburu J, Calvo FE, Moreno Rodríguez A, Tarabini-Castellani P, Heredero Gálvez E, Maicas Bellido C, Largo Pau J, Sepúlveda MA, Toledano Sierra P, Iqbal-Mirza SZ, Cascales Alcolea E, Egea Serrano P, Hernández Roca JJ, Keituqwa Yañez I, Peláez Ballesta A, Soriano V, Moreno Escobar E, Peña Monje A, Sánchez Cabrera V, Vinuesa García D, Arrizabalaga Asenjo M, Cifuentes Luna C, Núñez Morcillo J, Pérez Seco MC, Villoslada Gelabert A, Aured Guallar C, Fernández Abad N, García Mangas P, Matamala Adell M, Palacián Ruiz MP, Porres JC, Alcaraz Vidal B, Cobos Trigueros N, Del Amor Espín MJ, Giner Caro JA, Jiménez Sánchez R, Jimeno Almazán A, Ortín Freire A, Viqueira González M, Pericás Ramis P, Ribas Blanco MÁ, Ruiz de Gopegui Bordes E, Vidal Bonet L, Bellón Munera MC, Escribano Garaizabal E, Tercero Martínez A, Segura Luque JC. Role of age and comorbidities in mortality of patients with infective endocarditis. Eur J Intern Med 2019; 64:63-71. [PMID: 30904433 DOI: 10.1016/j.ejim.2019.03.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/22/2019] [Accepted: 03/05/2019] [Indexed: 02/08/2023]
Abstract
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.
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Affiliation(s)
- Carlos Armiñanzas
- Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.
| | - Concepción Fariñas-Alvarez
- Division of Health Care Quality, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
| | - Jesús Zarauza
- Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Spain.
| | - Víctor González Ramallo
- Servicio de Medicina Interna, Hospitalización a Domicilio, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Manuel Martínez Sellés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Universidad Europea, Universidad Complutense, Madrid, Spain.
| | - José Mª Miró Meda
- Servicio de Enfermedades Infecciosas, Hospital Clinic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain.
| | - Juan Manuel Pericás
- Servicio de Enfermedades Infecciosas, Hospital Clinic de Barcelona-IDIBAPS. Barcelona, Spain.
| | - Miguel Ángel Goenaga
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, San Sebastián, Spain
| | - Guillermo Ojeda Burgos
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Regino Rodríguez Álvarez
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Bilbao, Universidad del País Vasco, País Vasco, Spain.
| | - Laura Castelo Corral
- Servicio de Enfermedades Infecciosas, Complejo Hospitalario A Coruña, A Coruña, Spain
| | - Juan Gálvez-Acebal
- JUnidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena Instituto de Biomedicina de Sevilla, IBIS, Universidad de Sevilla, Sevilla, Spain.
| | | | - Maria Carmen Fariñas
- Maria Carmen Fariñas, Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana María Cuende
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | - Tomás Echeverría
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | - Ana Fuerte
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | - Eduardo Gaminde
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | | | - Pedro Idígoras
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | | | | | | | - Carlos Reviejo
- Hospital Universitario Donostia-Policlínica Gipuzkoa, San Sebastián, Spain
| | | | | | | | | | - Joaquín Plazas
- Hospital General Universitario de Alicante, Alicante, Spain
| | - Sergio Reus
- Hospital General Universitario de Alicante, Alicante, Spain
| | - Nemesio Álvarez
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - Laura Castelo
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - José Cuenca
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Pedro Llinares
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | | | - Efrén Sánchez
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Carlos Costas
- Hospital Universitario Central Asturias, Oviedo, Spain
| | | | | | | | | | | | | | | | | | - Carmen Palomo
- Hospital Universitario Central Asturias, Oviedo, Spain
| | | | | | | | | | - Manuel Almela
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Juan Ambrosioni
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Manuel Azqueta
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Mercè Brunet
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Marta Bodro
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Ramón Cartañá
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Carlos Falces
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Guillermina Fita
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - David Fuster
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | | | | | | | - Francesc Marco
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - José M Miró
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Asunción Moreno
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - David Nicolás
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Salvador Ninot
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Eduardo Quintana
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Carlos Paré
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Daniel Pereda
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Juan M Pericás
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - José L Pomar
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - José Ramírez
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Irene Rovira
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Elena Sandoval
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Marta Sitges
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Dolors Soy
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Adrián Téllez
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - José M Tolosana
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Bárbara Vidal
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Jordi Vila
- Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Iván Adán
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Bermejo
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Daniel Celemín
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | | | | | | | | | - Mercedes Marín
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Patricia Muñoz
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Rincón
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Blanca Pinilla
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Pinto
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Pilar Vázquez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | - Mar Moreno
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Iván García
- Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | - Ramón Teira
- Universitario Marqués de Valdecilla, Santander, Spain
| | - Jesús Zarauza
- Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Soledad Ruiz
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - Omar Araji
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | | | | | - Irene Méndez
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | | | - Emilio García
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | - Rafael Luque
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | | | | | | | | | - Mercé Gurguí
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Roser Pericas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Guillem Pons
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Álvarez
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - A L Fernández
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - Amparo Martínez
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - A Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - Benito Regueiro
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - E Tijeira
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - Marino Vega
- Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Blázquez
- Hospital Clínico Universitario Virgen de la Arrixaca Murcia, Spain
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