Irina Niculescu 1, A. Cupşa 1, I. Diaconescu 1, Florentina Dumitrescu 1, L. Giubelan 1, S. Dinescu 1, Manuela Muşa 2, Ştefania Ionescu 2
1 U.M.F. Craiova
2 Spitalul de Boli Infecţioase şi Pneumoftiziologie „Victor Babeş”, Craiova
Abstract
Background: Sepsis in elderly patients is an important cause of morbidity and mortality. Objectives: to establish the influence of age upon the incidence, etiology and evolution of sepsis. Methods: retrospective study (January 2006 – December 2006) on 278 patients with sepsis of 5219 patients hospitalized in Adult Clinics of Infectious Diseases Hospital “Victor Babes” Craiova. Incidence of sepsis, severe sepsis and septic shock, infection, etiology and evolution of sepsis were assessed on two groups of age. The two groups were: one with patients more than 65 years of age and other with patients less than 65 years of age. Results:16,1% of hospitalized patients were elderly individuals. Incidence of sepsis among hospitalized patients was 5,33%. Incidence of sepsis was significantly greater among older patients than among younger patients (7,62% versus 4,89%; RR=1,56; IC 95% – 1,19<RR<2,04; p=0,001). About one quarter of sepsis cases were elderly individuals (64/278). Incidence of severe sepsis was 12, 23% of sepsis cases (11,86% among older versus 12,8% among younger patients). Incidence of septic shock was significantly greater among older patients than among younger patients (7,81% versus 1,4%; RR=5,57; IC95%;1,37<RR<22,69; p=0,017) Although without statistically significance, differences in frequency of infections and etiology were recorded between two groups of patients. Germ was identified in 20% of cases. Elderly patients were more likely to develop infections due to gram-negative bacilli and gram-positive cocci than were younger patients (75% versus 39% respectivelly 25% versus 8%). Evolution of sepsis was unfavorably in 23,07% of cases among older patients versus 8,88% of cases among younger patients (p=0,023). Conclusions: Incidence of sepsis and septic shock was significantly greater among elderly than among younger patients. Infection among elderly patients with sepsis was represented more frequently by pneumonia, gastrointestinal infections, skin and soft tissue infections, and etiologically by gram-negative bacilli and gram-positive cocci, than among younger patients. Unfavorably evolution was significantly frequentlly among elderly patients than among younger patients.