Preprint Article Version 1 This version is not peer-reviewed

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

Version 1 : Received: 18 June 2019 / Approved: 19 June 2019 / Online: 19 June 2019 (10:00:15 CEST)

A peer-reviewed article of this Preprint also exists.

Cillóniz, C.; Dominedò, C.; Ielpo, A.; Ferrer, M.; Gabarrús, A.; Battaglini, D.; Bermejo-Martin, J.; Meli, A.; García-Vidal, C.; Liapikou, A.; Singer, M.; Torres, A. Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia. J. Clin. Med. 2019, 8, 961. Cillóniz, C.; Dominedò, C.; Ielpo, A.; Ferrer, M.; Gabarrús, A.; Battaglini, D.; Bermejo-Martin, J.; Meli, A.; García-Vidal, C.; Liapikou, A.; Singer, M.; Torres, A. Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia. J. Clin. Med. 2019, 8, 961.

Journal reference: J. Clin. Med. 2019, 8, 961
DOI: 10.3390/jcm8070961

Abstract

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.

Subject Areas

sepsis; community-acquired pneumonia; very old, pneumonia

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