• Medicina clinica · Dec 2024

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

    • Míriam Carbó Díez, Gina Osorio Quispe, Lourdes Artajona García, Marie Anette Arce Marañón, Natalia Miota Hernández, Dora Sempertegui Gutiérrez, Milagrosa Perea Gainza, and María Del Mar Ortega Romero.
    • Área de Urgencias, Hospital Clínic de Barcelona, Barcelona, España.
    • Med Clin (Barc). 2024 Dec 10.

    ObjectiveTo describe mortality predictive factors in patients 80years or older with infection who were visited at the emergency department and were admitted to hospital.MethodsRetrospective 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.Results987 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).ConclusionsqSOFA 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.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

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