Clinical Geriatrics
Published: 2020-07-15

Prognostic factors in older patients admitted in ICU with diagnosis of abdominal sepsis (sepsis-3 criteria)

Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy.
Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy
Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy
Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy
Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy
Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy.
elderly abdominal sepsis intensive care quickSOFA

Abstract

Background & aims. In septic older patients, hospitalization in Intensive Care Unit (ICU) is often associated with unfavourable outcomes. The aim of this study was to estimate the prevalence of geriatric age in patients admitted to ICU for abdominal sepsis and to investigate predictors of mortality, including quickSOFA, a recent prognostic index proposed for septic patients. Methods. Prospective observational study on patients admitted to ICU of St. Anna Hospital (Ferrara) between January and July 2016 with the following inclusion criteria: 1) adults (18 years); 2) abdominal infection treated with surgically techniques; 3) admission to ICU. Demographic, clinical data and survival at 30 and 90-day were collected for each patient. Results. Thirty patients were enrolled, and the majority of geriatric patients (80% ≥ 65 years and 53% ≥ 75 years). The 30 and 90-day mortality was 17 and 37%, respectively. Almost all deaths occurred in older age (mortality rate of 42%). SOFA (Sepsis Related Organ Failure Assessment) score was the prognostic index most frequently associated with exitus at 30 (AUC = 0.702) and 90 days (AUC = 0.730). quickSOFA was only related to early mortality (AUC = 0.640). Conclusions. Our data confirm the high geriatric prevalence among patients admitted to ICU for abdominal sepsis, underlining the advanced age as a negative prognostic factor. SOFA score appears a reliable prognostic indicator of mortality, also in older population, while quickSOFA proved effective only for short-term mortality.

Affiliations

Francesca Remelli

Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy.

Alberto Fogagnolo

Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy

Amedeo Zurlo

Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy

Carlo Alberto Volta

Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy

Savino Spadaro

Anesthesiology and Resuscitation Unit, Department of Morfology, Surgery and Sperimental Medicine, University of Ferrara, Italy

Stefano Volpato

Geriatrics e Ortogeriatrics Unit, Department of Medical Sciences, University of Ferrara, Italy.

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2020

How to Cite

[1]
Remelli, F., Fogagnolo, A., Zurlo, A., Volta, C.A., Spadaro, S. and Volpato, S. 2020. Prognostic factors in older patients admitted in ICU with diagnosis of abdominal sepsis (sepsis-3 criteria). JOURNAL OF GERONTOLOGY AND GERIATRICS. (Jul. 2020). DOI:https://doi.org/10.36150/2499-6564-391.
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