Hypothermia predicts mortality in critically ill elderly patients with sepsis
<p>Abstract</p> <p>Background</p> <p>Advanced age is one of the factors that increase mortality in intensive care. Sepsis and multi-organ failure are likely to further increase mortality in elderly patients.</p> <p>We compared the characteristics and outcome...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-09-01
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| Series: | BMC Geriatrics |
| Online Access: | http://www.biomedcentral.com/1471-2318/10/70 |
| _version_ | 1818662267838791680 |
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| author | Carney Ian Arora Subhash Gangopadhyay Himangsu Ong Kevin Tiruvoipati Ravindranath Botha John |
| author_facet | Carney Ian Arora Subhash Gangopadhyay Himangsu Ong Kevin Tiruvoipati Ravindranath Botha John |
| author_sort | Carney Ian |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Advanced age is one of the factors that increase mortality in intensive care. Sepsis and multi-organ failure are likely to further increase mortality in elderly patients.</p> <p>We compared the characteristics and outcomes of septic elderly patients (> 65 years) with younger patients (≤ 65 years) and identified factors during the first 24 hours of presentation that could predict mortality in elderly patients.</p> <p>Methods</p> <p>This study was conducted in a Level III intensive care unit with a case mix of medical and surgical patients excluding cardiac and neurosurgical patients.</p> <p>We performed a retrospective review of all septic patients admitted to our ICU between July 2004 and May 2007. In addition to demographics and co-morbidities, physiological and laboratory variables were analysed to identify early predictors of mortality in elderly patients with sepsis.</p> <p>Results</p> <p>Of 175 patients admitted with sepsis, 108 were older than 65 years. Elderly patients differed from younger patients with regard to sex, temperature (37.2°C VS 37.8°C p < 0.01), heart rate, systolic blood pressure, pH, HCO<sub>3</sub>, potassium, urea, creatinine, APACHE III and SAPS II. The ICU and hospital mortality was significantly higher in elderly patients (10.6% Vs 23.14% (p = 0.04) and 19.4 Vs 35.1 (p = 0.02) respectively). Elderly patients who died in hospital had a significant difference in pH, HCO<sub>3</sub>, mean blood pressure, potassium, albumin, organs failed, lactate, APACHE III and SAPS II compared to the elderly patients who survived while the mean age and co-morbidities were comparable. Logistic regression analysis identified temperature (OR [per degree centigrade decrease] 0.51; 95% CI 0.306- 0.854; p = 0.010) and SAPS II (OR [per point increase]: 1.12; 95% CI 1.016-1.235; p = 0.02) during the first 24 hours of admission to independently predict increased hospital mortality in elderly patients.</p> <p>Conclusions</p> <p>The mortality in elderly patients with sepsis is higher than the younger patients. Temperature (hypothermia) and SAPS II scores during the first 24 hours of presentation independently predict hospital mortality.</p> |
| first_indexed | 2024-12-17T04:58:15Z |
| format | Article |
| id | doaj.art-5bdc892c4d7c4607bc4a08a3716f84e4 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-17T04:58:15Z |
| publishDate | 2010-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-5bdc892c4d7c4607bc4a08a3716f84e42022-12-21T22:02:39ZengBMCBMC Geriatrics1471-23182010-09-011017010.1186/1471-2318-10-70Hypothermia predicts mortality in critically ill elderly patients with sepsisCarney IanArora SubhashGangopadhyay HimangsuOng KevinTiruvoipati RavindranathBotha John<p>Abstract</p> <p>Background</p> <p>Advanced age is one of the factors that increase mortality in intensive care. Sepsis and multi-organ failure are likely to further increase mortality in elderly patients.</p> <p>We compared the characteristics and outcomes of septic elderly patients (> 65 years) with younger patients (≤ 65 years) and identified factors during the first 24 hours of presentation that could predict mortality in elderly patients.</p> <p>Methods</p> <p>This study was conducted in a Level III intensive care unit with a case mix of medical and surgical patients excluding cardiac and neurosurgical patients.</p> <p>We performed a retrospective review of all septic patients admitted to our ICU between July 2004 and May 2007. In addition to demographics and co-morbidities, physiological and laboratory variables were analysed to identify early predictors of mortality in elderly patients with sepsis.</p> <p>Results</p> <p>Of 175 patients admitted with sepsis, 108 were older than 65 years. Elderly patients differed from younger patients with regard to sex, temperature (37.2°C VS 37.8°C p < 0.01), heart rate, systolic blood pressure, pH, HCO<sub>3</sub>, potassium, urea, creatinine, APACHE III and SAPS II. The ICU and hospital mortality was significantly higher in elderly patients (10.6% Vs 23.14% (p = 0.04) and 19.4 Vs 35.1 (p = 0.02) respectively). Elderly patients who died in hospital had a significant difference in pH, HCO<sub>3</sub>, mean blood pressure, potassium, albumin, organs failed, lactate, APACHE III and SAPS II compared to the elderly patients who survived while the mean age and co-morbidities were comparable. Logistic regression analysis identified temperature (OR [per degree centigrade decrease] 0.51; 95% CI 0.306- 0.854; p = 0.010) and SAPS II (OR [per point increase]: 1.12; 95% CI 1.016-1.235; p = 0.02) during the first 24 hours of admission to independently predict increased hospital mortality in elderly patients.</p> <p>Conclusions</p> <p>The mortality in elderly patients with sepsis is higher than the younger patients. Temperature (hypothermia) and SAPS II scores during the first 24 hours of presentation independently predict hospital mortality.</p>http://www.biomedcentral.com/1471-2318/10/70 |
| spellingShingle | Carney Ian Arora Subhash Gangopadhyay Himangsu Ong Kevin Tiruvoipati Ravindranath Botha John Hypothermia predicts mortality in critically ill elderly patients with sepsis BMC Geriatrics |
| title | Hypothermia predicts mortality in critically ill elderly patients with sepsis |
| title_full | Hypothermia predicts mortality in critically ill elderly patients with sepsis |
| title_fullStr | Hypothermia predicts mortality in critically ill elderly patients with sepsis |
| title_full_unstemmed | Hypothermia predicts mortality in critically ill elderly patients with sepsis |
| title_short | Hypothermia predicts mortality in critically ill elderly patients with sepsis |
| title_sort | hypothermia predicts mortality in critically ill elderly patients with sepsis |
| url | http://www.biomedcentral.com/1471-2318/10/70 |
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