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Med Intensiva. 2014 Jan-Feb;38(1):21-32. doi: 10.1016/j.medin.2012.12.006. Epub 2013 Feb 22.

[Epidemiology and long-term outcome of sepsis in elderly patients].

[Article in Spanish]

Author information

  • 1Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: carbajalmail@yahoo.com.
  • 2Unidad de salud pública, Distrito Sur, Sevilla, España.
  • 3Unidad Clínica de Cuidados Críticos y Urgencias, Hospital de la Merced, Osuna, España.
  • 4Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España.
  • 5Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Sevilla, España.

Abstract

OBJECTIVES:

A study was made of the epidemiological data of sepsis requiring admission to the ICU in patients over 65 years of age, with an evaluation of independent predictors of survival at 2 years.

DESIGN:

A prospective cohort study was made.

PATIENTS:

Patients meeting criteria for sepsis upon admission to the ICU.

SETTING:

A 40-bed ICU in a tertiary hospital.

RESULTS:

The study group included 237 elderly patients (≥ 65 years of age) and 281 controls (<65 years of age) (n=518). At least one chronic comorbid condition was present in 70% of the elderly patients as compared to only 56.1% of patients under age 65 (P<.01). There were several epidemiological differences between the groups: the prevalence of chronic diseases (diabetes, chronic obstructive pulmonary disease, and chronic heart failure), presentation as septic shock (52.3% vs 42%; P<.05), and the abdomen as the source of sepsis (52% vs 36%; P<.01) were all more frequent in elderly patients. Nine percent of the global patients discharged from hospital died in the 2-year follow-up period, but this rate reached 20% among the elderly. Independent predictors of 2-year mortality in the elderly were: chronic heart failure (adjusted hazard ratio [aHR] 2.24, 95% confidence interval [CI 95%] 1.28-3.94; P<.01), acute renal failure (aHR 3.64, 95%CI 2.10-6.23; P<.01), acute respiratory failure (aHR 3.67, 95%CI 2.31-5.86; P<.01), and inappropriate empirical antimicrobial therapy (aHR 2.19, 95%CI 1.32-3.62; P<.01).

CONCLUSIONS:

Sepsis showed different demographic characteristics and clinical presentations in the elderly. In the aging cohort, after adjusting for potential confounders, inadequate empirical antimicrobial therapy was associated to a 2-fold decrease in survival at two years.

Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

KEYWORDS:

Ancianos; Elderly; Long-term outcome; Prognosis; Pronóstico; Resultado a largo plazo; Sepsis

PMID:
23462427
[PubMed - in process]
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