Frailty as an Independent Predictor of Mortality in Patients with Sepsis.

Abstract

Objectives: Personalized sepsis care requires understanding how pre-existing health status can influence outcomes. The aim of this study is to evaluate its impact on in-hospital and 12-month mortality in patients with sepsis, taking into account age, comorbidities, the Charlson Comorbidity Index, frailty, anemia, and the Sequential Organ Failure Score Assessment (SOFA) in the first 24 h. Methods: An observational and retrospective study was conducted using data from the Sepsis Code program at the Hospital Universitario de La Princesa. The relationship between risk factors and mortality, as well as Intensive Care Unit (ICU) admission, was analyzed for the period 2016-2018 using bivariate and multivariate logistic regression. Results: A total of 547 patients were included. In the multivariate analysis, the risk factors independently associated with mortality were Rockwood Clinical Frailty Scale ≥ 5 (OR 2.45, p < 0.05); SOFA ≥ 4 (OR 2.13, p < 0.05); age (OR 1.98, p < 0.05); anemia (OR 1.85, p < 0.05); and specific comorbidities such as ischemic heart disease (OR 2.34, p < 0.05), severe liver disease (OR 3.62, p < 0.05), and metastatic cancer (OR 3.14, p < 0.05). Patients who were frail, had dementia, or heart failure were less likely to be admitted to the ICU. Conclusions: Frailty, comorbidities, age, and anemia are associated with outcomes in patients with sepsis and could be incorporated into mortality prediction models to guide tailored treatment strategies.