title: [Epidemiology and long-term outcome of sepsis in elderly patients].
abstract: OBJECTIVE
  A study was made of the epidemiological data of sepsis requiring admission to the ICU in patients over 65 years of age, with an evaluation of independent predictors of survival at 2 years.
  
  
  METHODS
  A prospective cohort study was made.
  
  
  METHODS
  Patients meeting criteria for sepsis upon admission to the ICU.
  
  
  METHODS
  A 40-bed ICU in a tertiary hospital.
  
  
  RESULTS
  The study group included 237 elderly patients (≥ 65 years of age) and 281 controls (<65 years of age) (n=518). At least one chronic comorbid condition was present in 70% of the elderly patients as compared to only 56.1% of patients under age 65 (P<.01). There were several epidemiological differences between the groups: the prevalence of chronic diseases (diabetes, chronic obstructive pulmonary disease, and chronic heart failure), presentation as septic shock (52.3% vs 42%; P<.05), and the abdomen as the source of sepsis (52% vs 36%; P<.01) were all more frequent in elderly patients. Nine percent of the global patients discharged from hospital died in the 2-year follow-up period, but this rate reached 20% among the elderly. Independent predictors of 2-year mortality in the elderly were: chronic heart failure (adjusted hazard ratio [aHR] 2.24, 95% confidence interval [CI 95%] 1.28-3.94; P<.01), acute renal failure (aHR 3.64, 95%CI 2.10-6.23; P<.01), acute respiratory failure (aHR 3.67, 95%CI 2.31-5.86; P<.01), and inappropriate empirical antimicrobial therapy (aHR 2.19, 95%CI 1.32-3.62; P<.01).
  
  
  CONCLUSIONS
  Sepsis showed different demographic characteristics and clinical presentations in the elderly. In the aging cohort, after adjusting for potential confounders, inadequate empirical antimicrobial therapy was associated to a 2-fold decrease in survival at two years.
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: carbajalmail@yahoo.com.
authors: J
authors: J
authors: Carbajal-Guerrero
authors: Unidad de salud pública, Distrito Sur, Sevilla, España.
authors: A
authors: A
authors: Cayuela-Domínguez
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital de la Merced, Osuna, España.
authors: E
authors: E
authors: Fernández-García
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors: T
authors: T
authors: Aldabó-Pallás
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors: J A
authors: JA
authors: Márquez-Vácaro
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Sevilla, España.
authors: C
authors: C
authors: Ortiz-Leyba
authors: Unidad Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Sevilla, España.
authors: J
authors: J
authors: Garnacho-Montero
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*; D015996:Survival Rate; D013997:Time Factors
keywords: Ancianos; Elderly; Long-term outcome; Prognosis; Pronóstico; Resultado a largo plazo; Sepsis