scholarly journals Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia

2019 ◽  
Vol 8 (7) ◽  
pp. 961 ◽  
Author(s):  
Cillóniz ◽  
Dominedò ◽  
Ielpo ◽  
Ferrer ◽  
Gabarrús ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Antibiotic Therapy ◽  
Lower Risk ◽  
Chronic Renal Disease ◽  
Community Acquired Pneumonia ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Very Old Patients

Background: Little is known about risk and prognostic factors in very old patients developing sepsis secondary to community-acquired pneumonia (CAP). Methods: We conducted a retrospective observational study of data prospectively collected at the Hospital Clinic of Barcelona over a 13-year period. Consecutive patients hospitalized with CAP were included if they were very old (≥80 years) and divided into those with and without sepsis for comparison. Sepsis was diagnosed based on the Sepsis-3 criteria. The main clinical outcome was 30-day mortality. Results: Among the 4219 patients hospitalized with CAP during the study period, 1238 (29%) were very old. The prevalence of sepsis in this age group was 71%. Male sex, chronic renal disease, and diabetes mellitus were independent risk factors for sepsis, while antibiotic therapy before admission was independently associated with a lower risk of sepsis. Thirty-day and intensive care unit (ICU) mortality did not differ between patients with and without sepsis. In CAP-sepsis group, chronic renal disease and neurological disease were independent risk factors for 30-day mortality. Conclusion: In very old patients hospitalized with CAP, in-hospital and 1-year mortality rates were increased if they developed sepsis. Antibiotic therapy before hospital admission was associated with a lower risk of sepsis.

scholarly journals Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired pneumonia

2019 ◽  
Author(s):  
Catia Cilloniz ◽  
Cristina Dominedò ◽  
Antonella Ielpo ◽  
Miquel Ferrer ◽  
Albert Gabarrus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Antibiotic Therapy ◽  
Lower Risk ◽  
Chronic Renal Disease ◽  
Community Acquired Pneumonia ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Very Old Patients

Background: Little is known about risk and prognostic factors in very old patients developing sepsis secondary to community-acquired pneumonia (CAP). Methods: We conducted a retrospective observational study of data prospectively collected at the Hospital Clinic of Barcelona over a 13-year period. Consecutive patients hospitalized with CAP were included if they were very old (≥80 years) and divided into those with and without sepsis for comparison. Sepsis was diagnosed based on the Sepsis-3 criteria. The main clinical outcome was 30-day mortality. Results: Among the 4,219 patients hospitalized with CAP during the study period, 1,238 (29%) were very old. The prevalence of sepsis in this aged group was 71%. Male sex, chronic renal disease, and diabetes mellitus were independent risk factors for sepsis, while antibiotic therapy before admission was independently associated with a lower risk of sepsis. Thirty-day and intensive care unit (ICU) mortality did not differ between patients with and without sepsis. In CAP-sepsis group, chronic renal disease and neurological disease were independent risk factors for 30-day mortality. Conclusion: In very old patients hospitalized with CAP, in-hospital and 1-year mortality rates were increased if they developed sepsis. Antibiotic therapy before hospital admission was associated with a lower risk of sepsis.

Clinical Features and Mortality of Nosocomial Candidemia in Very Old Patients: A Multicentre Italian Study

Gerontology ◽  
2020 ◽  
Vol 66 (6) ◽  
pp. 532-541
Author(s):  
Marta Zatta ◽  
Stefano Di Bella ◽  
Daniele Roberto Giacobbe ◽  
Filippo Del Puente ◽  
Maria Merelli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Catheter ◽  
Prognostic Impact ◽  
Old Patients ◽  
Very Old ◽  
Probability Of Survival ◽  
Independent Risk Factors ◽  
Nosocomial Candidemia ◽  
Medical Wards ◽  
Few Data

<b><i>Introduction:</i></b> Being elderly is a well-known risk factor for candidemia, but few data are available on the prognostic impact of candidemia in the very old (VO) subjects, as defined as people aged ≥75 years. <b><i>Objective:</i></b> The aim of this study was to assess risk factors for nosocomial candidemia in two groups of candidemia patients, consisting of VO patients (≥75 years) and adult and old (AO) patients (18–74 years). In addition, risk factors for death (30-day mortality) were analysed separately in the two groups. <b><i>Methods:</i></b> We included all consecutive candidemia episodes from January 2011 to December 2013 occurring in six referral hospitals in north-eastern Italy. <b><i>Results:</i></b> A total of 683 nosocomial candidemia episodes occurred. Of those, 293 (42.9%) episodes were in VO and 390 (57.1%) in AO patients. Hospitalization in medical wards, chronic renal failure, urinary catheter, and peripheral parenteral nutrition (PPN) were more common in VO than in AO patients. In the former patient group, adequate antifungal therapy (73.2%) and central venous catheter (CVC) removal (67.6%) occurred less frequently than in AO patients (82.5 and 80%, <i>p</i> &#x3c; 0.002 and <i>p</i> &#x3c; 0.004, respectively). Thirty-day mortality was higher in VO compared to AO patients (47.8 vs. 23.6%, <i>p</i> &#x3c; 0.0001). In AO patients, independent risk factors for death were age (OR 1.04, 95% CI 1.00–1.09, <i>p</i> = 0.038), recent history of chemotherapy (OR 22.01, 95% CI 3.12–155.20, <i>p</i> = 0.002), and severity of sepsis (OR 40.68, 95% CI 7.42–223.10, <i>p</i> &#x3c; 0.001); CVC removal was associated with higher probability of survival (OR 0.10, 95% CI 0.03–0.33, <i>p</i> &#x3c; 0.001). In VO patients, independent risk factors for death were PPN (OR 3.5, 95% CI 1.17–10.47, <i>p</i> = 0.025) and hospitalization in medical wards (OR 2.58, 95% CI 1.02–6.53, <i>p</i> = 0.046), while CVC removal was associated with improved survival (OR 0.40, 95% CI 0.16–1.00, <i>p</i> = 0.050). <b><i>Conclusion:</i></b> Thirty-day mortality was high among VO patients and was associated with inadequate management of candidemia, especially in medical wards.

scholarly journals Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

2020 ◽  
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Verónica Buonaiuto ◽  
Michele Ricci ◽  
Jesica Martín-Carmona ◽  
Diana Paredes-Ruíz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Atherosclerotic Cardiovascular Disease ◽  
X Rays ◽  
Old Patients ◽  
Very Old ◽  
Independent Risk Factors ◽  
Male Sex

Abstract Background Advanced age is a well-known risk factor for poor prognosis in COVID-19. However, few studies have specifically focused on very old inpatients with COVID-19. This study aims to describe the clinical characteristics of very old inpatients with COVID-19 and identify risk factors for in-hospital mortality at admission. Methods We conducted a nationwide, multicenter, retrospective, observational study in patients ≥ 80 years hospitalized with COVID-19 in 150 Spanish hospitals (SEMI-COVID-19) Registry (March 1–May 29, 2020). The primary outcome was in-hospital mortality. A uni- and multivariate logistic regression was performed to assess predictors of mortality at admission. Results A total of 2772 consecutive patients (49.4% men, median age 86.3 years) were analyzed. Rates of atherosclerotic cardiovascular disease, diabetes mellitus, dementia, and Barthel Index &lt; 60 were 30.8%, 25.6%, 30.5%, and 21.0%, respectively. The overall case-fatality rate was 46.9% (n: 1301) and increased with age (80–84 years: 41.6%; 85–90 years: 47.3%; 90–94 years: 52.7%; ≥95 years: 54.2%). After analysis, male sex and moderate-to-severe dependence were independently associated with in-hospital mortality; comorbidities were not predictive. At admission, independent risk factors for death were: oxygen saturation &lt; 90%; temperature ≥ 37.8°C; quick sequential organ failure assessment (qSOFA) score ≥ 2; and unilateral–bilateral infiltrates on chest x-rays. Some analytical findings were independent risk factors for death, including estimated glomerular filtration rate &lt; 45 mL/min/1.73 m2; lactate dehydrogenase ≥ 500 U/L; C-reactive protein ≥ 80 mg/L; neutrophils ≥ 7.5 × 103/μL; lymphocytes &lt; 0.8 × 103/μL; and monocytes &lt; 0.5 × 103/μL. Conclusions This first large, multicenter cohort of very old inpatients with COVID-19 shows that age, male sex, and poor preadmission functional status—not comorbidities—are independently associated with in-hospital mortality. Severe COVID-19 at admission is related to poor prognosis.

scholarly journals Age- and Gender-Specific Prevalence of Risk Factors in Patients with First-Ever Ischemic Stroke in China

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiao-ying Yao ◽  
Yan Lin ◽  
Jie-li Geng ◽  
Ya-meng Sun ◽  
Ying Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Heart Diseases ◽  
Vascular Risk ◽  
Age And Gender ◽  
Old Patients ◽  
Very Old ◽  
History Of ◽  
And Gender ◽  
Very Old Patients

Background. Evidences are accumulating that age and gender have great impact on the distribution of stroke risk factors. Such data are lacking in Chinese population.Methods. 1027 patients with first-ever ischemic stroke (IS) were recruited and divided into young adult (<50 years), middle-aged (50∼80 years), and very old (>80 years) groups according to stroke onset ages. Vascular risk factors were collected and compared among groups.Results. Female patients were globally older than male patients at stroke onset and having higher prevalence of diabetes mellitus (DM), heart diseases, and atrial fibrillation (AF). However, females were less likely to drink heavily or smoke than males. Young patients had a much higher proportion of smoking and drinking than middle-aged and very old patients and the highest family history of hypertension, while very old patients had the highest prevalence of heart diseases and AF but lowest proportion of positive family history of vascular diseases. Hypertension and DM were equally frequent among three groups.Conclusion. Our study showed that vascular risk factors had a specific age and gender distribution pattern in Chinese IS patients. Secondary prevention strategy should emphasize on the control of different risk factors based on patient’s age and gender.

Prevalence and risk factors of sepsis in very old patients with CAP

2019 ◽  
Author(s):  
Catia Cilloniz Campos ◽  
Cristina Dominedò ◽  
Antonella Ielpo ◽  
Miquel Ferrer ◽  
Albert Gabarrús ◽  
...  
Keyword(s):  
Risk Factors ◽  
Old Patients ◽  
Very Old ◽  
Very Old Patients

Renal creatinine handling in very old patients with chronic renal disease

2010 ◽  
Vol 43 (3) ◽  
pp. 899-902 ◽  
Author(s):  
Carlos G. Musso ◽  
Hernán Michelángelo ◽  
Manuel Vilas ◽  
Bernardo Martinez ◽  
Alberto Bonetto ◽  
...  
Keyword(s):  
Renal Disease ◽  
Chronic Renal Disease ◽  
Old Patients ◽  
Very Old ◽  
Very Old Patients

Escherichia colibacteraemia in adults: age-related differences in clinical and bacteriological characteristics, and outcome

2014 ◽  
Vol 142 (12) ◽  
pp. 2672-2683 ◽  
Author(s):  
C. ROUBAUD BAUDRON ◽  
X. PANHARD ◽  
O. CLERMONT ◽  
F. MENTRÉ ◽  
B. FANTIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Death Rate ◽  
The Elderly ◽  
Age Group ◽  
Old Patients ◽  
Very Old ◽  
Comorbidity Score ◽  
Age Related ◽  
Very Old Patients

SUMMARYTo explore the specificities ofEscherichia colibacteraemia in the elderly, the demographic, clinical and bacteriological characteristics and in-hospital mortality rate of ‘young’ (18–64 years,n = 395), ‘old’ (65–79 years,n = 372) and ‘very old’ (⩾80 years,n = 284) adult patients of the multicentre COLIBAFI cohort study were compared. Clinical and bacteriological risk factors for death were jointly identified by logistic regression and multivariate analysis within each group. ‘Young’ and ‘old’ patients had more comorbidities than ‘very old’ patients (comorbidity score: 1·5 ± 1·3 and 1·6 ± 1·2vs. 1·2 ± 1·2, respectively;P < 0·001), and were more frequently nosocomially infected (22·3% and 23·8%vs. 8·8%, respectively;P < 0·001). ‘Old’ patients had the poorest prognosis (death rate: 16·4%vs.10·4% for ‘young’ and 12·0% for ‘very old’ patients, respectively;P = 0·039). Risk factors for death were age group-specific, suggesting a host–pathogen relationship evolving with age.

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