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Aim <p>To evaluate risk factors affecting the prognosis of sepsis in elderly patients.</p> Method <p>The study was conducted retrospectively in a secondary healthcare institution between 2016 and 2023. Elderly patients (&gt; 65 years) admitted with sepsis were included. Demographic data, laboratory parameters on the day of diagnosis, sepsis origin, causative microorganisms, and mortality on the 28th day were recorded.</p> Results <p>A total of 179 elderly patients were included. The median age was 82 and 44% were male. The mortality rate was 49% on the 28th day. Hypertension was more common in the non-survived patients. Blood urea nitrogen (OR 1.03 (1.00-1.05) <i>p</i> = 0.007), and albumin (OR 0.26 (0.10–0.62) <i>p</i> = 0.003), levels were a predictor of mortality at the time of the admission. In the non-survived patients, Systemic inflammatory response syndrome (SIRS) and quick sepsis-related organ failure assessment scores were higher at the time of sepsis diagnosis (<i>p</i> &lt; 0.001). The rate of septic shock (79.5% vs. 33%), intensive care unit (99% vs. 90%), mechanical ventilation (87.5% vs. 55%), and vasopressor needs (55% vs. 27.5%) were significantly higher in the non-survived patients. The rate of bacteremia was found to be higher in the non-survived patient group (26%) than in the survivors (13.2%). The rate of Gram-negative microorganisms was significantly higher in the non-survived patient group than in the survivors (63% vs. 27%; <i>p</i> &lt; 0.001). The most frequently isolated bacteria were <i>Klebsiella pneumoniae</i> (33%) in blood culture; it was <i>Escherichia coli</i> (35%) in urine cultures and <i>Acinetobacter baumanii</i> (40%) in sputum cultures. On the 3-5th day of treatment, the clinical response rate was lower in the non-survived patient group (29%) than in the surviving’s (53%) (<i>p</i> = 0.001). The most important determinants for the mortality were hypertension (OR 2.39 (1.25–4.95) <i>p</i> = 0.019), SIRS score (OR 1.86 (1.32–2.61) <i>p</i> &lt; 0.001) and Gram-negative bacteria sepsis (OR 2.53 (1.22–5.22), <i>p</i> = 0.012).</p> Conclusion <p>The number and the proportion of the elderly population is increasing worldwide, and sepsis is one of the most common causes of death in elderly patients. Knowing the poor prognostic factors is important for early treatment and to reduce mortality.</p>

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Sepsis in elderly patients: investigation of prognostic factors in a secondary healthcare facility

  • 期刊论文

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  • 发表日期：

    2025年7月10日

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  • Dilek Dülger,
  • Zeynep Ture,
  • Ayşe Yolcu,
  • Esma Eryılmaz Eren,
  • Nevin Sanlier,
  • Emine Alp

摘要

Aim

To evaluate risk factors affecting the prognosis of sepsis in elderly patients.

Method

The study was conducted retrospectively in a secondary healthcare institution between 2016 and 2023. Elderly patients (> 65 years) admitted with sepsis were included. Demographic data, laboratory parameters on the day of diagnosis, sepsis origin, causative microorganisms, and mortality on the 28th day were recorded.

Results

A total of 179 elderly patients were included. The median age was 82 and 44% were male. The mortality rate was 49% on the 28th day. Hypertension was more common in the non-survived patients. Blood urea nitrogen (OR 1.03 (1.00-1.05) p = 0.007), and albumin (OR 0.26 (0.10–0.62) p = 0.003), levels were a predictor of mortality at the time of the admission. In the non-survived patients, Systemic inflammatory response syndrome (SIRS) and quick sepsis-related organ failure assessment scores were higher at the time of sepsis diagnosis (p < 0.001). The rate of septic shock (79.5% vs. 33%), intensive care unit (99% vs. 90%), mechanical ventilation (87.5% vs. 55%), and vasopressor needs (55% vs. 27.5%) were significantly higher in the non-survived patients. The rate of bacteremia was found to be higher in the non-survived patient group (26%) than in the survivors (13.2%). The rate of Gram-negative microorganisms was significantly higher in the non-survived patient group than in the survivors (63% vs. 27%; p < 0.001). The most frequently isolated bacteria were Klebsiella pneumoniae (33%) in blood culture; it was Escherichia coli (35%) in urine cultures and Acinetobacter baumanii (40%) in sputum cultures. On the 3-5th day of treatment, the clinical response rate was lower in the non-survived patient group (29%) than in the surviving’s (53%) (p = 0.001). The most important determinants for the mortality were hypertension (OR 2.39 (1.25–4.95) p = 0.019), SIRS score (OR 1.86 (1.32–2.61) p < 0.001) and Gram-negative bacteria sepsis (OR 2.53 (1.22–5.22), p = 0.012).

Conclusion

The number and the proportion of the elderly population is increasing worldwide, and sepsis is one of the most common causes of death in elderly patients. Knowing the poor prognostic factors is important for early treatment and to reduce mortality.