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Revista Habanera de Ciencias Médicas
versão On-line ISSN 1729-519X
Resumo
HERNANDEZ OLIVA, Mijail et al. Prognostic factors for mortality in elderly patients admitted to intensive care units with sepsis. Rev haban cienc méd [online]. 2020, vol.19, n.1, pp. 63-75. Epub 01-Fev-2020. ISSN 1729-519X.
Introduction:
Sepsis is defined as a life-threatening organ dysfunction caused by an unregulated host response to infection.
Objective:
To identify prognostic factors for mortality in patients 65 years old or older admitted with sepsis to the Intensive Care Unit of “Aleida Fernandez Chardiet” Teaching General Hospital between 2012 and 2017.
Material and Methods:
An observational analytical retrospective study was conducted. The study population was 129 elderly patients who were diagnosed with sepsis.
Results:
A total of 316 patients were admitted with sepsis; 187 of them were under 65 years old and 129 were 65 years old or older. The average APACHE II scores were much higher in those patients who could not survive (161; p˂0, 01); SOFA scores were (6, 3±2,4; 95% CI 5,8-6,8; p˂0,01). The ROC curve showed an area under the curve for APACHE II which was found to be 0,834 (95% CI 0,761-0,907) and for SOFA it was 0,941 (95% CI 0,903-0,980). On the other hand, 77,6% of patients died with septic shock (OR=47,5; 95% CI 13,2-170,5; p˂0,01) and a multiple-organ dysfunction syndrome, which was observed in 67,1% of them (OR=47,8; 95% CI 9,6-189,5; p˂0,01). According to multivariate logistic regression model, the variables significantly associated to mortality were APACHE II score ≥15 points (adjusted OR 10, 7; 95% CI 2, 8-40, 4) and SOFA ≥5 points (adjusted OR 43, 9; 95% CI 2, 3-826, 8). The model calibration was adequate (X2=5,7; p=0,336).
Conclusions:
The prognostic factors for mortality in elderly patients admitted with sepsis in the service were as follows: APACHE II score ≥ 15 points and SOFA score ≥5 points.
Palavras-chave : Sepsis; prognostic factors; elderly; mortality; intensive care.