E Forestier1, C Roubaud-Baudron2, T Fraisse3, C Patry4, G Gavazzi5, B Hoen6, P Carauz-Paz7, B Moheb-Khosravi8, F Delahaye9, G Sost10, M Paccalin11, P Nazeyrollas12, C Strady13, F Alla14, C Selton-Suty15. 1. Infectious Diseases Department, Centre Hospitalier Metropole Savoie, Chambéry, France. Electronic address: Emmanuel.forestier@ch-metropole-savoie.fr. 2. CHU Bordeaux, Department of Geriatric Medicine, Univ. Bordeaux, F-33000, Bordeaux, France. 3. Department of Geriatric Medicine, Centre Hospitalier Alès Cévennes, Alès, France. 4. Department of Geriatrics, Hôpital Bichat - APHP, Paris, France. 5. Department of Geriatric Medicine and GREPI EA 7408, University Hospital of Grenoble-Alpes, Grenoble, France. 6. Infectious Diseases and Internal Medicine Department and INSERM CIC 1424, University Hospital of Pointe-à-Pitre; Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Bastaraud, EA 4537, Pointe-à-Pitre, France. 7. Infectious Diseases Department, Centre Hospitalier Intercommunal Lucie et Raymond Aubrac, Villeneuve Saint Georges, France. 8. Department of Geriatric Medicine, Centre Hospitalier Annecy Genevois, Annecy, France. 9. Cardiology Department, Hospices civils de Lyon, Université Claude Bernard Lyon 1, HESPER, EA 7425, Lyon, France. 10. Department of Geriatric Medicine, University Hospital of Rennes, Rennes, France. 11. Department of Geriatric Medicine and CIC 1402, University Hospital of Poitiers, Poitiers, France. 12. Cardiology Department, University Hospital of Reims, Reims, France. 13. Infectious Diseases Department, Groupe Courlancy, Reims, France. 14. Clinical Epidemiological Center, University Hospital of Nancy, Nancy, France. 15. Cardiology Department, University Hospital of Nancy, Nancy, France.
Abstract
OBJECTIVES: The aim was to describe the impact of infective endocarditis (IE) on functional, cognitive and nutritional statuses, and to estimate the influence of these parameters on surgical management and mortality. METHOD: This was a prospective study over 13 months in 14 French hospitals, including patients ≥75 years of age with definite or possible IE. A comprehensive geriatric assessment (CGA) was performed during the first week of hospitalization, including a retrospective estimation of functional status 2 months before hospitalization, and 3 months after. RESULTS: A total of 120 patients were included (mean age 83.1 ± 5.0 (75-101) years). IE was associated with a dramatic impairment of functional status between 2 months prior hospitalization and the first geriatric evaluation (90.8% able to walk vs. 35.5% (p < 0.0001), ADL (Activities in Daily Living) 5.0 ± 1.7 vs. 3.1 ± 2.1 (p < 0.0001)). The 19 operated patients (15.8%) had less comorbidities (cumulative illness rating scale geriatric 10.8 ± 8.2 vs. 15.3 ± 7.1 (p 0.0176)), better functional (ADL 5.9 ± 0.4 vs. 4.9 ± 1.8 (p 0.0171) and nutritional (mini nutritional assessment 20.4 ± 5.0 vs. 17.3 ± 6.2 (p 0.0501)) statuses than non-operated patients. Among all infectious, cardiac and geriatric parameters, body mass index (HR 0.9, range 0.8-1, p 0.05) and ADL at the time of the first evaluation (HR 0.7, range 0.6-0.9, p 0.002) were the sole independent predictors of the 3-month (32.5%) and 1-year mortality (42.5%). Three months later, the 57 assessed patients only partially recovered their ADL (3.7 ± 1.9 vs. 5.3 ± 1.4 2 months prior hospitalization and 4.6 ± 1.9 at the first CGA; p < 0.0001). CONCLUSION: Functional and nutritional abilities are crucial components that can be accurately explored through a CGA when managing IE in oldest patients.
OBJECTIVES: The aim was to describe the impact of infective endocarditis (IE) on functional, cognitive and nutritional statuses, and to estimate the influence of these parameters on surgical management and mortality. METHOD: This was a prospective study over 13 months in 14 French hospitals, including patients ≥75 years of age with definite or possible IE. A comprehensive geriatric assessment (CGA) was performed during the first week of hospitalization, including a retrospective estimation of functional status 2 months before hospitalization, and 3 months after. RESULTS: A total of 120 patients were included (mean age 83.1 ± 5.0 (75-101) years). IE was associated with a dramatic impairment of functional status between 2 months prior hospitalization and the first geriatric evaluation (90.8% able to walk vs. 35.5% (p < 0.0001), ADL (Activities in Daily Living) 5.0 ± 1.7 vs. 3.1 ± 2.1 (p < 0.0001)). The 19 operated patients (15.8%) had less comorbidities (cumulative illness rating scale geriatric 10.8 ± 8.2 vs. 15.3 ± 7.1 (p 0.0176)), better functional (ADL 5.9 ± 0.4 vs. 4.9 ± 1.8 (p 0.0171) and nutritional (mini nutritional assessment 20.4 ± 5.0 vs. 17.3 ± 6.2 (p 0.0501)) statuses than non-operated patients. Among all infectious, cardiac and geriatric parameters, body mass index (HR 0.9, range 0.8-1, p 0.05) and ADL at the time of the first evaluation (HR 0.7, range 0.6-0.9, p 0.002) were the sole independent predictors of the 3-month (32.5%) and 1-year mortality (42.5%). Three months later, the 57 assessed patients only partially recovered their ADL (3.7 ± 1.9 vs. 5.3 ± 1.4 2 months prior hospitalization and 4.6 ± 1.9 at the first CGA; p < 0.0001). CONCLUSION: Functional and nutritional abilities are crucial components that can be accurately explored through a CGA when managing IE in oldest patients.
Authors: Carlos Bea; Sara Vela; Sergio García-Blas; Jose-Angel Perez-Rivera; Pablo Díez-Villanueva; Ana Isabel de Gracia; Eladio Fuertes; Maria Rosa Oltra; Ana Ferrer; Andreu Belmonte; Enrique Santas; Mauricio Pellicer; Javier Colomina; Alberto Doménech; Vicente Bodi; Maria José Forner; Francisco Javier Chorro; Clara Bonanad Journal: J Cardiovasc Dev Dis Date: 2022-06-17
Authors: Shekhar Saha; Ralitsa Mladenova; Caroline Radner; Konstanze Maria Horke; Joscha Buech; Philipp Schnackenburg; Ahmad Ali; Sven Peterss; Gerd Juchem; Maximilian Luehr; Christian Hagl; Dominik Joskowiak Journal: J Clin Med Date: 2022-06-22 Impact factor: 4.964