Study Of Clinical Profile Of Sepsis In Geriatric Patients And Predictors Of Mortality

Abstract

Background: Sepsis is a global healthcare issue and continues to cause high mortality especially in elderly patients. The present study was undertaken to study the clinical profile of sepsis in geriatric patients and to determine the predictors of mortality. Method: A total
201 patients of either sex, age >60 years with clinical and laboratory evidence of sepsis as per
the International Sepsis definitions Conference criteriawere included in the study. Results:
Out of 201 patients, 73.1% had comorbidity. 27.3% patients were found to be in septic shock
on admission with mean arterial pressure ≤65mmHg according to sepsis 3 defining
criteria.About 21% patients had culture negative sepsis. 39% patients had gram negative
sepsis; 12% patients had gram positive sepsis.Pneumonia was the most common observed
infection (33.8%), followed by urinary tract infection (24.4%), cellulitis (13.4%).56.7%
patients required mechanical ventilation (MV) with survival of only 40.5%. Need for MV
was found to be highly related to mortality (p<0.001). About 34.3% patients were provided
with renal replacement therapy (RRT) and out of 69 only 34(16.92%) survived despite
therapy, (p=0.004).Out of all the factors studied upon univariate analysis Age, SBP, Oxygen
saturation, PaO2/FiO2 ratio, GCS score, haemoglobin, serum lactate levels, SOFAS score on
day 1,3,5 were found to be significant predictors of mortality. On Multivariate regression
analysis, significant predictors of mortality as an outcome were age, GCS score on admission,
lower haemoglobin, increased Serum lactate and SOFAS score on Day 1 & 5.Conclusion:
Present study described the clinical profile and mortality predictive factors in geriatric patients
with sepsis. These informative predictors would inform clinical practice to adopt effective
therapeutic strategies to improve patient outcomes.