Predictive factors of mortality in very old patients visited in Emergency Department and admitted for infection.

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Míriam Carbó Díez, Gina Osorio Quispe, Lourdes Artajona García, Marie Anette Arce Marañón, Natalia Miota Hernández, Dora Sempertegui Gutiérrez, Milagrosa Perea Gainza, María Del Mar Ortega Romero
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引用次数: 0

Abstract

Objective: To describe mortality predictive factors in patients 80years or older with infection who were visited at the emergency department and were admitted to hospital.

Methods: Retrospective observational study. Patients ≥80years old who visited the emergency department (January 1st to December 31st, 2022), whose main diagnosis was infection and required admission, were included. Factors associated with mortality at the end of the episode were determined.

Results: 987 patients were included (mean age 87years, 53% women). Mortality at the end of the episode was 13% (n=127). Median survival of the series was 52days (95%CI: 44-60). The independent factors related to mortality were: age (HR: 1.07; 95%CI: 1.03-1.11; P<.001), frailty (Clinical Frailty Scale [CFS]) (HR: 1.51; 95%CI: 1.15-1.97; P=.003), qSOFA (HR: 1.35; 95%CI: 1.07-1.70; P=.01), SOFA (HR: 1.23; 95%CI: 1.15-1.38; P<.001), leukocyte count (HR: 1.04; 95%CI: 1.02-1.06; P<.001) and criteria for sepsis and/or septic shock (HR: 2.52; 95%CI: 1.63-3.87; P<.001). On the contrary, any type of microbiological isolation was associated with lower mortality (HR: 0.44; 95%CI: 0.29-0.64; P<.001).

Conclusions: qSOFA and SOFA scores, the sepsis and septic shock criteria, as well as frailty are predictive factors of poor prognosis in very elderly patients who come to the emergency room due to infection. Knowing frailty would allow us to adapt the treatment and therapeutic effort to the patient's characteristics.

急诊科就诊并因感染入院的高龄患者死亡率的预测因素
目的:探讨80岁及以上急诊科就诊并住院的感染患者的死亡率预测因素。方法:回顾性观察研究。纳入2022年1月1日至12月31日急诊就诊、主要诊断为感染、需住院的≥80岁患者。确定与发作结束时死亡率相关的因素。结果:纳入987例患者(平均年龄87岁,女性53%)。发作结束时的死亡率为13% (n=127)。该系列的中位生存期为52天(95%CI: 44-60)。与死亡率相关的独立因素有:年龄(HR: 1.07;95%置信区间:1.03—-1.11;结论:qSOFA和SOFA评分、脓毒症和脓毒性休克标准以及虚弱是因感染就诊的高龄患者预后不良的预测因素。了解虚弱将使我们能够根据病人的特点调整治疗和治疗努力。
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来源期刊
Medicina Clinica
Medicina Clinica 医学-医学:内科
CiteScore
3.10
自引率
5.10%
发文量
295
审稿时长
22 days
期刊介绍: Medicina Clínica, fundada en 1943, es una publicación quincenal dedicada a la promoción de la investigación y de la práctica clínica entre los especialistas de la medicina interna, así como otras especialidades. Son características fundamentales de esta publicación el rigor científico y metodológico de sus artículos, la actualidad de los temas y, sobre todo, su sentido práctico, buscando siempre que la información sea de la mayor utilidad en la práctica clínica.
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