Risk and prognostic factors in very old patients with sepsis secondary to community-acquired pneumonia

Catia Cillóniz, Cristina Dominedò, Antonella Ielpo, Miquel Ferrer, Albert Gabarrús, Denise Battaglini, Jesús Bermejo-Martin, Andrea Meli, Carolina García-Vidal, Adamanthia Liapikou, Mervyn Singer, Antoni Torres

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Resumen

Background: Little is known about risk and prognostic factors in very old patients developing sepsis secondary to community-acquired pneumonia (CAP). Methods: We conducted a retrospective observational study of data prospectively collected at the Hospital Clinic of Barcelona over a 13-year period. Consecutive patients hospitalized with CAP were included if they were very old (≥80 years) and divided into those with and without sepsis for comparison. Sepsis was diagnosed based on the Sepsis-3 criteria. The main clinical outcome was 30-day mortality. Results: Among the 4219 patients hospitalized with CAP during the study period, 1238 (29%) were very old. The prevalence of sepsis in this age group was 71%. Male sex, chronic renal disease, and diabetes mellitus were independent risk factors for sepsis, while antibiotic therapy before admission was independently associated with a lower risk of sepsis. Thirty-day and intensive care unit (ICU) mortality did not differ between patients with and without sepsis. In CAP-sepsis group, chronic renal disease and neurological disease were independent risk factors for 30-day mortality. Conclusion: In very old patients hospitalized with CAP, in-hospital and 1-year mortality rates were increased if they developed sepsis. Antibiotic therapy before hospital admission was associated with a lower risk of sepsis.

Idioma originalInglés estadounidense
-961
PublicaciónJournal of Clinical Medicine
Volumen8
N.º7
DOI
EstadoIndizado - jul. 2019
Publicado de forma externa

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© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

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