{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:08:29Z","timestamp":1790507309568,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,4,11]],"date-time":"2021-04-11T00:00:00Z","timestamp":1618099200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Japan CO., LTD, Boston Scientific"},{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["17H04141"],"award-info":[{"award-number":["17H04141"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health, Labour and Welfare, Japan","award":["19AA2007"],"award-info":[{"award-number":["19AA2007"]}]},{"name":"Ministry of Health, Labour and Welfare, Japan","award":["H30-Policy-Designated-004"],"award-info":[{"award-number":["H30-Policy-Designated-004"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,3,25]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The current status of surgical treatment for infective endocarditis (IE) among very elderly people is unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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 (&lt;65 years), elderly (65\u201379 years) and very elderly (\u226580 years). A 1:1 propensity score matching was performed to compare proportions of surgical treatment and in-hospital mortality among the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 20\u2009667 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%\u2009CI 0.43 to 0.85).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001627","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T11:58:16Z","timestamp":1618228696000},"page":"e001627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Surgical treatment for infective endocarditis in the ageing society: a nationwide retrospective study in Japan"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-3141","authenticated-orcid":false,"given":"Hiroyuki","family":"Kiriyama","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-6170","authenticated-orcid":false,"given":"Hidehiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan"},{"name":"Department of Advanced Cardiology, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Kamon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojiro","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo-ku, Japan"},{"name":"Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, Japan"},{"name":"Department of Advanced Cardiology, The University of Tokyo, Bunkyo-ku, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Daimon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Tokyo, Bunkyo-ku, 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