Details

Autor(en) / Beteiligte

• Patrizio, Enrica
• Zambon, Antonella
• Mazzola, Paolo
• Massariello, Francesca
• Galeazzi, Marianna
• Cavalieri d’Oro, Luca
• Bonfanti, Paolo
• Bellelli, Giuseppe

Titel

Assessing the mortality risk in older patients hospitalized with a diagnosis of sepsis: the role of frailty and acute organ dysfunction

Ist Teil von

• Aging clinical and experimental research, 2022-10, Vol.34 (10), p.2335-2343

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Background A prognostic stratification of mortality risk in older patients with sepsis admitted to medical wards is often challenging. Aims To evaluate the ability of the Sequential Organ Failure Assessment (SOFA) score, serum biomarkers (lactate and C-Reactive Protein, CRP), and measures of comorbidity and frailty in predicting in-hospital and 6-month mortality in a cohort of older patients admitted to an Acute Geriatric Unit (AGU) with a diagnosis of sepsis. Methods All patients aged 70 years and over consecutively admitted to our AGU with sepsis in the study period were included. At admission, a Comprehensive Geriatric Assessment including two measures of frailty (Clinical Frailty Scale [CFS], Frailty Index [FI]) was obtained. To assess the predictivity of candidate prognostic markers, the Area Under the Receiver-Operating Characteristic (AUROC) curves were analyzed. A multivariate logistic regression analysis was also performed. Results We included 240 patients (median age = 85, IQR = 80–89, 40.8% women), of whom 33.8% died before discharge, and 60.4% at 6 months. The SOFA score (AUROC = 0.678, 95% CI 0.610–0.747) and CRP serum levels (AUROC = 0.606, 95% CI 0.532–0.680) were good predictors of in-hospital mortality. The CFS (AUROC = 0.703, 95% CI 0.637–0.768) and the FI (AUROC = 0.677, 95% CI 0.607–0.746) better predicted 6-month mortality. Results of the regression analysis confirmed the findings of the AUROC study. The combined assessment of SOFA and measures of frailty improved the performance of the model both in the short and the long term. Conclusions Both the severity of organ dysfunction and frailty scores should be addressed on AGU admission to establish the short- and long-term outcomes of older patients with sepsis.