title: Short-term prognostic factors in the elderly patients seen in emergency departments due to infections.
abstract: OBJECTIVE
  To analyse factors associated with short-term mortality in elderly patients seen in emergency departments (ED) for an episode of infectious disease.
  
  
  METHODS
  A prospective, observational, multicentre, analytical study was carried out on patients aged 75years and older who were treated in the ED of one of the eight participating hospitals. An assessment was made of 26 independent variables that could influence mortality at 30days. They covered epidemiological, comorbidity, functional, clinical and analytical factors. Multivariate logistic regression analysis was performed.
  
  
  RESULTS
  The study included 488 consecutive patients, 92 (18.9%) of whom died within 30days of visiting the ED. Three variables were significantly associated with higher mortality: severe functional dependence, with Barthel index ≤60 [odds ratio (OR) 8,92; 95% confidence interval (CI): 4.98-15.98, P=.003], systolic blood pressure <90mmHg [OR 7.34; 95%CI: 4.39-12.26, P=.005] and serum lactate >4mmol/l [OR 21.14; 95%CI: 8.94-49.97, P=.001]. The area under the curve for the model was 0.971 (95%CI: 0.951-0.991; P<.001).
  
  
  CONCLUSIONS
  Several factors evaluated in an initial assessment in the ED, including the level of functional dependence, systolic blood pressure and, especially, serum lactate, were found to determine a poor short-term prognosis in the elderly patients who presented with an episode of an infectious disease.
authors.affiliation: Servicio de Urgencias, Complejo Hospitalario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es.
authors.forename: Agustín
authors.initials: A
authors.lastname: Julián-Jiménez
authors.affiliation: Servicio de Urgencias, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: Juan
authors.initials: J
authors.lastname: González-Del-Castillo
authors.affiliation: Servicio de Urgencias, Hospital Universitario de Basurto, Bilbao, España.
authors.forename: Mikel
authors.initials: M
authors.lastname: Martínez-Ortiz-de-Zárate
authors.affiliation: Servicio de Urgencias, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Arranz-Nieto
authors.affiliation: Servicio de Urgencias, Hospital Virgen de la Luz, Cuenca, España.
authors.forename: Félix
authors.initials: F
authors.lastname: González-Martínez
authors.affiliation: Servicio de Urgencias, Hospital Universitario Reina Sofía, Murcia, España.
authors.forename: Pascual
authors.initials: P
authors.lastname: Piñera-Salmerón
authors.affiliation: Servicio de Urgencias, Hospital Universitario Virgen de la Macarena, Sevilla, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro-Bustos
authors.affiliation: Servicio de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
authors.forename: César
authors.initials: C
authors.lastname: Henríquez-Camacho
authors.affiliation: Servicio de Urgencias, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: Eric Jorge
authors.initials: EJ
authors.lastname: García-Lamberechts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007239:Infections / Q000401:mortality*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
keywords: Anciano; Dependencia funcional; Elderly; Emergency department; Factores pronósticos; Functional dependence; Lactato sérico; Mortalidad; Mortality; Prognostic factors; Serum lactate; Servicios de urgencias