Multimorbidity and geriatric syndromes: their effect on mortality in older adults with sepsis

Mortality in older adults with sepsis

Abstract

Introduction: sepsis is diagnosed in more than 60% of older adults (OA) in the world. These OAs frequently present multimorbidity and geriatric syndromes, leading to physical, cognitive and psychosocial disability, which produces high costs for health systems, resulting a major public health problem.

Objective: to identify the impact of multimorbidity and geriatric syndromes on the mortality of OAs hospitalized for sepsis in an acute geriatric unit 30 days after admission.

Materials and methods: Observational, analytical case-control study nested in a cohort.

Results: 238 patients were analyzed with a mean age of 83.15 ± 7.12 years, 52.1% were women and 99% had at least one comorbidity, mortality at 30 days was 34%. Urinary infection was the main cause of hospitalization (42.9%), obtaining microbiological isolation in 43.3% of the cases, Escherichia coli being the most frequent causal agent (46.6%). Multiple logistic regression showed that chronic kidney disease (OR 2.1, 95% CI 1.1-4.8, p=0.037), delirium (OR 3.1 95% CI 1.6-5.8, p=0.001) and disability (Barthel index <60; OR 3.4 95% CI 1.5-7.5, p=0.002) were significantly associated with mortality at 30 days from admission to the acute geriatric unit in a patient with sepsis.

Conclusion: In OAs hospitalized for sepsis, multimorbidity and geriatric syndromes represented by chronic kidney disease, delirium and disability were the predictors of mortality at 30 days.