Is mortality in elderly septic patients as high as expected? Long-term mortality in a surgical sample cohort

Med Intensiva (Engl Ed). 2019 Nov;43(8):464-473. doi: 10.1016/j.medin.2018.05.003. Epub 2018 Jul 17.
[Article in English, Spanish]

Abstract

Purpose: To determine the differences in short- and long-term mortality in elderly septic patients with multiorgan dysfunction syndrome and establish the factors related to non-survival.

Materials and methods: A retrospective cohort study was made of 206 patients over 65 years of age with septic and septic shock criteria admitted to the ICU of Rio Hortega Hospital between January 2011 and February 2017. Study variables were obtained from electronic database records.

Results: A total of 206 patients were included, divided into three groups of age (65-74, 75-85, >85 years). There were no significant differences in mortality according to age group after 28 days, 90 days or one year (28.6%, 32.1% and 45.2% in the 65-74 years age group; 32.5%, 38.6% and 45.8% in the 75-85 years age group, 41%, 48.7% and 56.4% in the >85 years age group). The factors related to mortality were: chronic heart failure, non-haematological cancer, liver dysfunction and central nervous system dysfunction.

Conclusions: The results indicate that there is no significant difference in mortality among the different age groups. About 50% of the elderly patients survive a septic process. There is a close relationship between the number of affected organs and days of dysfunction, the use of interventional techniques and long-term mortality.

Keywords: Ancianos; Disfunción multiorgánica; Elderly; Multiorgan dysfunction; Outcomes; Resultados; Sepsis; Septic Shock; Shock séptico.

MeSH terms

  • APACHE
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Cohort Studies
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Kaplan-Meier Estimate
  • Multiple Organ Failure / mortality*
  • Organ Dysfunction Scores
  • Postoperative Complications / mortality*
  • Retrospective Studies
  • Sepsis / mortality*
  • Shock, Septic / mortality
  • Time Factors