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Hospital and 1-Year Outcomes of Septic Syndromes in Older People: A Cohort Study

¹ INECO, Centro de Estudios de la Memoria y Conducta, Buenos Aires, Argentina.
² Vita Cátedra de Medicina, Hospital de Clínicas, Buenos Aires, Argentina.
³ Hospital de Clínicas and "Laboratorio Metabolismo del Oxígeno," Hospital de Clínicas, Buenos Aires, Argentina.
⁴ Pulmonary Division, Hospital de Clínicas, Buenos Aires, Argentina.

Address correspondence to Carlos Javier Regazzoni, MD, PhD, INECO, Centro de Estudios de la Memoria y Conducta, Castex 3293 (C1425CDC) Buenos Aires, Argentina. E-mail: cregazzoni{at}intramed.net

Abstract

Purpose. Our objective was to describe the relationship between sepsis syndrome mortality and cognitive and physical disability in elderly persons.

Methods. A 1-year consecutive cohort study in clinical beds of a university hospital was performed. Variables were severity of sepsis syndrome, organ failure, functional status, age, sex, and positive cultures. Outcomes were in-hospital and 1-year mortalities.

Results. The study included 137 patients (>70 years), both sexes. Data from 116 (84.5%) patients were obtainable at 1-year follow-up. Forty-eight (35%) patients presented with sepsis (11/137, 8%) or severe sepsis (37/137, 27%). In-hospital mortality was 15.3% (0% for sepsis and 21.8% if severe) and increased with organ failure (p <.0001). One-year mortality was 54.78% (63/116), mostly related to severe sepsis; predictors were severe organ failure (p <.0001), prior functional status (p =.0005), and Mini-Mental State Examination (p =.03). Prior functional status and organ failure were independent predictors.

Conclusions. In-hospital and 1-year mortality increased with septic syndrome severity, prior functional status, and organ failure.

Key Words: Sepsis—Septic syndrome—Organ failure—Functional capacity