Sepsis and Septic Shock: Outcomes in Elderly and  Very Elderly Intensive Care Patients

YAPAÖZ, melda; Candemir, Burcu; Aygencel, Gulbin; İnci, Kamil

doi:10.4274/tybd.galenos.2019.41275

Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients

Burcu CANDEMİR, (Gazi Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Geriatri Anabilim Dalı, Ankara, Türkiye)

Kamil İNCİ, (Gazi Üniversitesi, Tıp Fakültesi, Dahiliye Bölümü, Yoğun Bakım Anabilim Dalı, Ankara, Türkiye)

Gülbin AYGENCEL, (Gazi Üniversitesi, Tıp Fakültesi, Dahiliye Bölümü, Yoğun Bakım Anabilim Dalı, Ankara, Türkiye)

Melda ALTIKATOĞLU YAPAÖZ (Gazi Üniversitesi, Tıp Fakültesi, Dahiliye Bölümü, Yoğun Bakım Anabilim Dalı, Ankara, Türkiye)

Türk Yoğun Bakım Dergisi

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Yıl: 2022 Cilt: 20 Sayı: 1 Sayfa Aralığı: 9 - 16 Metin Dili: İngilizce DOI: 10.4274/tybd.galenos.2019.41275 İndeks Tarihi: 14-10-2022

Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients

Öz:

Objective: The relationship between age and the development and outcome of sepsis and septic shock is unclear, especially in adults. There are few studies about the incidence, prognosis and mortality rates of sepsis in elderly and very elderly patients. In this study, we aimed to determine the effect of age on the outcome of sepsis and septic shock in elderly and very elderly intensive care unit (ICU) patients. Materials and Methods: This study was a retrospective observational study conducted in our medical ICU. Two hundred elderly and very elderly patients with sepsis and septic shock were included in this study. Results: The mortality rate related to sepsis and septic shock was 61.5% (123 patients). The most common site of infection was lung (56.5%, 113 patients), followed by urinary tract (35%, 70 patients). There was no significant difference between the elderly (61.2%, 82 patients) and the very elderly (62.1%, 41 patients) patients in terms of ICU mortality related to sepsis and septic shock (p>0.05). Sequential Organ Failure Assessment score on ICU admission [1.195 odds ratio (OR) and 1.052-1.358 95% confidence interval (CI), p=0.006], requirement of invasive mechanical ventilation on ICU admission (4.330 OR and 1.529-12.258 95% CI, p=0.006), renal impairment at the end of the ICU follow-up (6.457 OR and 1.795-23.233 95% CI, p=0.004) and the disability to feed orally in ICU (0.064 OR and 0.018-0.226 95% CI, p=0.0001) were found as independent risk factors for ICU mortality. Conclusion: According to our study, there was no significant difference between the elderly and the very elderly ICU patients with sepsis and septic shock in terms of mortality rates. However, the presence of organ damage during ICU admission and the development of complications during ICU stay significantly affected mortality.

Anahtar Kelime:

Sepsis ve Septik Şok: Yaşlı ve Çok Yaşlı Yoğun Bakım Hastalarının Sonuçları

Öz:

Amaç: Sepsis-septik şok gelişimi ile yaşın ilişkisi özellikle erişkinlerde açık değildir. Yaşlı ve çok yaşlı hastalarda sepsis ve septik şokun insidans, prognoz ve mortalitesi ile ilgili az sayıda çalışma bulunmaktadır. Bu çalışma ile yaşlı ve çok yaşlı yoğun bakım ünitesi (YBÜ) hastalarında yaşın sepsis ve septik şokun sonuçları üzerine etkisini göstermeyi amaçladık. Gereç ve Yöntem: Bu çalışma YBÜ’de yapılan retrospektif gözlemsel bir çalışma olup 200 yaşlı ve çok yaşlı sepsis-septik şok hastası çalışmaya alınmıştır. Bulgular: Sepsis-septik şok ilişkili mortalite oranı %61,5 (123 hasta) idi. En sık enfeksiyon odağı akciğer (%56,5, 113 hasta) ve üriner sistemdi (%35, 70 hasta). Yaşlı (%61,2, 82 hasta) ve çok yaşlı hastalar (%62,1, 41 hasta) arasında mortalite açısından anlamlı fark yoktu. YBÜ kabülünde Sıralı Organ Yetmezliği Değerlendirme skoru [1,195 olasılık oranı (OR) ve 1,052-1,358 %95 güven aralığı (GA), p=0,006] ve invazif mekanik ventilasyon gereksinimi (4,330 OR ve 1,529-12,258 %95 GA, p=0,006), YBÜ takibinin sonunda böbrek yetmezliği gelişmesi (6,457 OR ve 1,795-23,233 %95 GA, p=0,004) ve oral yoldan beslenme yetersizliği (0,064 OR ve 0,018-0,226 %95 GA, p=0,0001) YBÜ mortalitesi için bağımsız risk faktörleri olarak bulundu. Sonuç: Bu çalışmada yaşlı ve çok yaşlı hastalar arasında sepsis-septik şoka bağlı mortalite oranları açısından anlamlı bir fark yoktu. Ancak YBÜ’ye kabulü sırasında organ hasarı varlığı ve takipte komplikasyon gelişimi mortaliteyi etkilemekteydi.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Candemir B, İnci K, Aygencel G, YAPAÖZ m (2022). Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. , 9 - 16. 10.4274/tybd.galenos.2019.41275
Chicago	Candemir Burcu,İnci Kamil,Aygencel Gulbin,YAPAÖZ melda Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. (2022): 9 - 16. 10.4274/tybd.galenos.2019.41275
MLA	Candemir Burcu,İnci Kamil,Aygencel Gulbin,YAPAÖZ melda Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. , 2022, ss.9 - 16. 10.4274/tybd.galenos.2019.41275
AMA	Candemir B,İnci K,Aygencel G,YAPAÖZ m Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. . 2022; 9 - 16. 10.4274/tybd.galenos.2019.41275
Vancouver	Candemir B,İnci K,Aygencel G,YAPAÖZ m Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. . 2022; 9 - 16. 10.4274/tybd.galenos.2019.41275
IEEE	Candemir B,İnci K,Aygencel G,YAPAÖZ m "Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients." , ss.9 - 16, 2022. 10.4274/tybd.galenos.2019.41275
ISNAD	Candemir, Burcu vd. "Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients". (2022), 9-16. https://doi.org/10.4274/tybd.galenos.2019.41275

APA	Candemir B, İnci K, Aygencel G, YAPAÖZ m (2022). Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. Türk Yoğun Bakım Dergisi, 20(1), 9 - 16. 10.4274/tybd.galenos.2019.41275
Chicago	Candemir Burcu,İnci Kamil,Aygencel Gulbin,YAPAÖZ melda Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. Türk Yoğun Bakım Dergisi 20, no.1 (2022): 9 - 16. 10.4274/tybd.galenos.2019.41275
MLA	Candemir Burcu,İnci Kamil,Aygencel Gulbin,YAPAÖZ melda Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. Türk Yoğun Bakım Dergisi, vol.20, no.1, 2022, ss.9 - 16. 10.4274/tybd.galenos.2019.41275
AMA	Candemir B,İnci K,Aygencel G,YAPAÖZ m Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. Türk Yoğun Bakım Dergisi. 2022; 20(1): 9 - 16. 10.4274/tybd.galenos.2019.41275
Vancouver	Candemir B,İnci K,Aygencel G,YAPAÖZ m Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients. Türk Yoğun Bakım Dergisi. 2022; 20(1): 9 - 16. 10.4274/tybd.galenos.2019.41275
IEEE	Candemir B,İnci K,Aygencel G,YAPAÖZ m "Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients." Türk Yoğun Bakım Dergisi, 20, ss.9 - 16, 2022. 10.4274/tybd.galenos.2019.41275
ISNAD	Candemir, Burcu vd. "Sepsis and Septic Shock: Outcomes in Elderly and Very Elderly Intensive Care Patients". Türk Yoğun Bakım Dergisi 20/1 (2022), 9-16. https://doi.org/10.4274/tybd.galenos.2019.41275