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2018, Number 4

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Rev Hosp Jua Mex 2018; 85 (4)

Sepsis in the critically ill elderly patient

Hernández-López GD, Amezcua-Gutiérrez MA, Gorordo-Delsol LA, Cruz-Montesinos S, Zamora-Gómez SE, Lima-Lucero IM; Garduño-López J, Montoya-Rojo JO, Escobar OD

Language: Spanish
References: 15
Page: 222-227
PDF size: 177.96 Kb.


ABSTRACT

Background: Elderly patients comprise an increasing proportion of intensive care unit (ICU) admissions. Advanced age and multiple comorbidities compromise their immunity and hence they may be more prone to succumbing to severe infection and have poorer outcome. We undertook this study to review impact of severe sepsis on mortality in the elderly patients. Methods: All patients admitted to a medical ICU from Hospital Juárez de México during the period of January 2012 to July 2016 with sepsis diagnostic were included. Patients were divided into young groups (younger than 60 years) and older (≥ 60 years). Data regarding baseline patient characteristics, admission APACHE II score, and ICU course including need for organ support and ICU length of stay were noted. The data are presented as absolute values and percentages. To determine mortality, the odds ratio was calculated, with 95% confidence intervals. A value of p ‹ 0.1 was considered statistically significant. Statistical analysis was performed using IBM SPSS 21.0 software. Primary outcome measure was the ICU mortality. Results: 175 patients were included in the analysis. The most common suspected site of infection was lungs (34.8%), followed by abdomen (33.1%), NSC (8%) and soft tissue (8%). Intensive care unit mortality in older patients was 20%. The odds ratio (OR) for dying was 0.5332 in the elderly patients. There was an increased need for organ support in the elderly population, 4% required renal replacement therapy. Conclusions: The risk of dying from severe sepsis is considerably higher in the elderly group of patients however the age is an independent risk factor for mortality. Hence, early aggressive care to recognize and manage severe sepsis is required to improve outcome in the elderly patient.


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