| アブストラクト | OBJECTIVE: The current status of surgical treatment for infective endocarditis (IE) among very elderly people is unclear. METHODS: We extracted data on patients in Japan with community-acquired IE who were admitted and discharged between April 2010 and February 2018 using a nationwide inpatient, the Diagnosis Procedure Combination database. We divided patients into three groups: non-elderly (<65 years), elderly (65-79 years) and very elderly (>/=80 years). A 1:1 propensity score matching was performed to compare proportions of surgical treatment and in-hospital mortality among the groups. RESULTS: We identified 20 667 eligible patients (median age 70 years, 61.0% men). The proportion of very elderly patients significantly increased (19.1% in 2010 to 29.7% in 2018). The proportion of surgical treatment was significantly lower, and in-hospital mortality was significantly higher in very elderly patients. This tendency was more pronounced among patients with in-hospital complications such as heart failure, stroke or embolism. Surgical treatment was significantly associated with lower in-hospital mortality even in very elderly patients, both in an unmatched (OR 0.61; 95% CI 0.47 to 0.78) and a propensity score matched cohort (OR 0.61; 95% CI 0.43 to 0.85). CONCLUSIONS: The proportion of very elderly patients with IE was increasing, and very elderly patients had higher in-hospital mortality. The proportion of surgical treatment for IE among very elderly patients was low, but it was associated with lower in-hospital mortality. Further studies are needed to establish the optimal strategy for IE among very elderly patients. |
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| ジャーナル名 | Open heart |
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| 投稿日 | 2021/4/14 |
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| 投稿者 | Kiriyama, Hiroyuki; Kaneko, Hidehiro; Itoh, Hidetaka; Kamon, Tatsuya; Morita, Kojiro; Jo, Taisuke; Fujiu, Katsuhito; Daimon, Masao; Takeda, Norifumi; Morita, Hiroyuki; Yasunaga, Hideo; Komuro, Issei |
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| 組織名 | Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan;kiriyaman0427@gmail.com.;Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan.;Department of Advanced Cardiology, The University of Tokyo, Bunkyo-ku, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Bunkyo-ku, Japan.;Department of Health Services Research, Faculty of Medicine, University of;Tsukuba, Tsukuba, Japan.;Department of Health Services Research, The University of Tokyo, Bunkyo-ku,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33846222/ |
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