The importance of source control in the treatment of infections in elderly patients aged 80 and above

Abstract

Background

There is currently no research in super-elderly patients with source of infections that require invasive treatment

Objectives

We retrospectively examined the impact on outcomes of performing or not performing such procedures in super-elderly patients with infection sources

Methods

The subjects were patients aged 80 years or older who were transported by ambulance to Numazu City Hospital and diagnosed with "infections requiring source control" in the emergency department during the six-year period. Infections requiring source control were generally defined as infections for which procedures such as drainage, debridement, or surgical resection to physically reduce the bacterial load at the source were necessary

Results

There were 201 patients were enrolled. The average age was 87.0 years. There were 175 cases where procedures were performed, and 24 cases (11.9 %) resulted in death. Hepatobiliary diseases were the most common, accounting for 153 cases, followed by renal infections with 25 cases. Compared to the surviving group, the fatal group had a statistically significantly lower rate of source control, shorter hospital stays, and higher Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores. Among them, only source control was identified as an independent factor related to survival by multivariate analysis

Conclusion

This study suggests that performing source control in patients, even those aged 80 years and older, might increase survival rates