Influence of underlying condition and performance of sepsis bundle in very old patients with sepsis: a nationwide cohort study
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Sepsis is a life-threatening condition that affects individuals of all ages; however, it presents unique challenges in very old patients due to their complex medical histories and potentially compromised immune systems. This study aimed to investigate the influence of underlying conditions and the performance of sepsis bundle protocols in very old patients with sepsis. METHODS: We conducted a nationwide cohort study of adult patients with sepsis prospectively collected from the Korean Sepsis Alliance Database. Underlying conditions, prognosis, and their association with sepsis bundle compliance in patients with sepsis aged ≥ 80 years were analyzed. RESULTS: Among the 11,981 patients with sepsis, 3,733 (31.2%) were very old patients aged ≥ 80 years. In-hospital survivors (69.8%) were younger, less likely male, with higher BMI, lower Charlson Comorbidity Index, lower Clinical Frailty Scale, and lower Sequential Organ Failure Assessment (SOFA) scores. The in-hospital survivor group had lower lactate measurement but higher fluid therapy and vasopressor usage within the 1-h bundle. Similar trends were seen in the 3-h and 6-h bundles. Furthermore, in-hospital survivors were more likely to receive appropriate empiric antibiotics within 24 h. In-hospital mortality was associated with age, Clinical Frailty Scale, SOFA score, comorbidities, Life sustaining treatment issue, interventions in the ICU and vasopressor use in the 1-h sepsis bundle. CONCLUSIONS: Addressing underlying conditions and enhancing sepsis bundle adherence is crucial for better outcomes in very old patients with sepsis. Personalized approaches and increased awareness are essential. Further research should explore interventions to optimize sepsis care in this population.
Source: Annals of Intensive Care
Authors: Duk Ki Kim, Soyun Kim, Da Hyun Kang, Hyekyeong Ju, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, YunKyong Hyon, Song I Lee, Kyeongman Jeon, Sunghoon Park, Yeon Joo Lee, Sang-Bum Hong, Gee Young Suh, Young-Jae Cho, Ryoung-Eun Ko, Sung Yoon Lim, Jeongwon Heo, Jae-myeong Lee, Kyung Chan Kim, Yeon Joo Lee, Youjin Chang, Kyeongman Jeon, Sang-Min Lee, Suk-Kyung Hong, Woo Hyun Cho, Sang Hyun Kwak, Heung Bum Lee, Jong-Joon Ahn, Gil Myeong Seong, Song I Lee, Sunghoon Park, Tai Sun Park, Su Hwan Lee, Eun Young Choi, Jae Young Moon
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,390
Funders: Seoul National University Bundang Hospital, Korea Disease Control and Prevention Agency, Hanyang University, Catholic University of Daegu, Jeju National University, Chonnam National University, Chungnam National University, Kangwon National University, Pusan National University, Seoul National University, Hallym University, Inje University, Korea University, Yeungnam University, Seoul National University Hospital, Chungnam National University Hospital, Jeju National University Hospital, Jeonbuk National University, Korea University Anam Hospital, Samsung, Korea Centers for Disease Control and Prevention, Ulsan University Hospital
OpenAlex ID: W4404998476