Critically ill elderly adults with infection: analysis of the extended prevalence of infection in intensive care study.
OBJECTIVE
To determine the effect of age on patterns of infection and on outcomes in individuals with infection.


METHODS
Analysis of data from an international, observational, point-prevalence study: Extended Prevalence of Infection in Intensive Care (EPIC II).


METHODS
Intensive care units (ICUs; N=1,265) in 75 countries.


METHODS
All adults present in a participating ICU on May 8, 2007. Individuals with an infection were included and classified according to age (18–44, 45–64, 65–74, 75–84, ≥85).


METHODS
Demographic, physiological, bacteriological, and therapeutic data were collected on the day of the study. Outcome data were collected until hospital discharge or for 60 days.


RESULTS
Of the 13,796 adults enrolled in EPIC II, 7,087 (51.4%) had an infection. Of these, 330 (4.7%) were aged 85 and older, 1,405 (19.8%) were 75 to 84, 1,713 (24.2%) were 65 to 74, 2,358 (33.3%) were 45 to 64, and 1,281 (18.1%) were 18 to 44. Severity of illness did not differ between groups. Those aged 85 and older had fewer bloodstream infections than those younger than 75, fewer central nervous system infections than those who were younger than 65, and more abdominal infections than those who were younger than 45. A microbiological diagnosis was established less frequently in participants aged 85 and older than in younger participants. Gram-negative microorganisms were more frequently isolated in those aged 85 and older than in other groups. ICU and hospital mortality were significantly higher in participants aged 85 and older than in those who were younger than 65.


CONCLUSIONS
A large proportion of individuals in the ICU with infection are aged 65 and older. Patterns of infection, including site and type of microorganism, vary according to age. Being aged 85 and older was an independent risk factor for mortality in individuals in the ICU with infection.
Department of Critical Care Medicine, Attikon University Hospital, Athens, Greece.
George
G
Dimopoulos
Department of Critical Care Medicine, Attikon University Hospital, Athens, Greece.
Despoina
D
Koulenti
Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
Stijn
S
Blot
Department of Anesthesiology and Intensive Care, Friedrich-Schiller University, Jena, Germany.
Yasser
Y
Sakr
Department of Pulmonary and Critical Care and South Texas Veterans Health Care System, University of Texas Health Science Center, San Antonio, Texas.
Antonio
A
Anzueto
Department of Anesthesiology and Intensive Care, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-University Medicine Berlin, Berlin, Germany.
Claudia
C
Spies
Intensive Care Unit, Hospital Dr Negrín, Las Palmas de Gran Canaria, Spain.
Jordi
J
Solé-Violán
Division of Pulmonary and Critical Care, Department of Medicine, Miller School of Medicine University of Miami and Jackson Memorial Hospital, Miami, Florida.
Daniel
D
Kett
Department of Critical Care Medicine, Attikon University Hospital, Athens, Greece.
Apostolos
A
Armaganidis
Department of Anesthesiology and Intensive Care, Hospital Nord, Marseille, France.
Claude
C
Martin
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Jean Louis
JL
Vincent
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016638:Critical Illness; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors