title: Comparison of intensive-care-unit-acquired infections and their outcomes among patients over and under 80 years of age.
abstract: BACKGROUND
  Patients aged >80 years represent a growing population admitted to intensive care units (ICUs). However, little is known about ICU-acquired infection (IAI) in this population, and the rate of invasive procedures is increasing.
  
  
  OBJECTIVE
  To evaluate the frequency and effects of IAI in elderly (≥80 years) and younger patients.
  
  
  METHODS
  Retrospective evaluation of consecutive patients hospitalized for three days or more over a three-year period in an 18-bed ICU in an academic medical centre.
  
  
  RESULTS
  Elderly patients represented 18.9% of the study population. At admission, the mean number of organ dysfunctions was similar in elderly and younger patients. The use of invasive procedures was also similar in elderly and younger patients, as follows: invasive mechanical ventilation for more than two days, 67.4% vs 55%; central venous catheterization, 56.9% vs 51.4%; and renal replacement therapy, 17.6% vs 17.8%, respectively. The frequency of IAI was 16.5% in elderly patients and 13.9% in younger patients (P = 0.28), with 20.5 vs 18.9 IAI episodes per 1000 ICU-days, respectively (P = 0.2). A Cox model identified central venous catheterization and invasive mechanical ventilation for more than two days as independent risk factors for IAI. The associations between IAI and prolonged ICU stay, increased nursing workload, and ICU and hospital mortality rates were similar in elderly and younger patients.
  
  
  CONCLUSIONS
  The frequency of IAI was similar in elderly and younger patients, as were the associations between IAI and length of ICU stay, nursing workload and ICU mortality in an ICU with a high rate of invasive procedures.
authors.affiliation: Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine, Paris, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Maillet
authors.affiliation: Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine, Paris, France. Electronic address: emmanuel.guerot@egp.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Guérot
authors.affiliation: Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Novara
authors.affiliation: Université Paris Descartes, Faculté de Médecine, Paris, France; Service de Gériatrie, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Le Guen
authors.affiliation: Université Paris Descartes, Faculté de Médecine, Paris, France; Service de Gériatrie, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Lahjibi-Paulet
authors.affiliation: UF Hygiène Hospitalière, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Kac
authors.affiliation: Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine, Paris, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Diehl
authors.affiliation: Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine, Paris, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Fagon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Elderly; ICU-acquired infection; Intensive care unit; Outcome; Risk factors