title: Surgical site infections and mortality in elderly patients.
abstract: OBJECTIVE
  We present the characteristics and outcome of surgical site infections (SSI) in patients 65 years of age or more, and determine the factors influencing mortality.
  
  
  METHODS
  We conducted a prospective observational cohort study, comparing patients who survived with those who died, to identify risk factors associated with mortality among elderly patients presenting with SSI. The diagnosis of SSI was made for each patient, according to the CDC's standardized criteria.
  
  
  RESULTS
  Seventy-five patients presenting with SSI were included in the study. The mean age of patients was 75 ± 6 (65-92), 68% were male patients. The most frequently isolated pathogen was Acinetobacter baumannii (n = 24). The overall in-hospital mortality rate was 25.3%. The statistical analysis revealed that gastrointestinal surgery, organ/space infections, polymicrobial infections, and higher SOFA scores were significantly associated with hospital mortality (P = 0.005, P = 0.0001, P = 0.047, P = 0.0001). According to laboratory tests, higher white blood cell (WBC) and neutrophil count, higher total bilirubin level, and lower thrombocyte count and albumin levels were significantly associated with hospital mortality (P = 0.040, P = 0.014, P = 0.001, P = 0.019, P=0.002). Multivariate analyses revealed that serum albumin (P = 0.004, OR = 11.3, CI 95% 2.16-59.07), organ/space SSI (P = 0.0001, OR = 11.65, CI 95% 3.003-45.21), and SOFA score (P = 0.030, OR = 2.742, 1.100-6.84) were independent risk factors associated with mortality.
  
  
  CONCLUSIONS
  Serum albumin levels, organ/space infections, and higher SOFA scores were independently significantly associated with hospital mortality in older patients with SSI. Serum albumin levels should be closely monitored, and if necessary, early surgery should be performed.
authors.affiliation: Mersin University, Faculty of Medicine, Department of Infectious Diseases, 33079 Mersin, Turkey. Electronic address: sahinelif@gmail.com.
authors.forename: E S
authors.initials: ES
authors.lastname: Horasan
authors.forename: A
authors.initials: A
authors.lastname: Dağ
authors.forename: G
authors.initials: G
authors.lastname: Ersoz
authors.forename: A
authors.initials: A
authors.lastname: Kaya
mesh_terms: D000151:Acinetobacter Infections / Q000401:mortality; D040981:Acinetobacter baumannii; D000368:Aged; D000369:Aged, 80 and over; D003955:Diagnostic Tests, Routine; D004927:Escherichia coli Infections / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology; D007964:Leukocytosis / Q000453:epidemiology; D008297:Male; D009102:Multiple Organ Failure / Q000401:mortality; D011300:Preoperative Care; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000401:mortality; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000097:blood / Q000401:mortality*; D014421:Turkey / Q000453:epidemiology
keywords: Elderly; Infections du site opératoire; Mortality; Mortalité; Patients âgés; Surgical site infection