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Serum albumin is a strong predictor of sepsis outcome in elderly patients

  • Isabel Arnau-Barrés
  • Robert Güerri-FernándezEmail author
  • Sonia Luque
  • Luisa Sorli
  • Olga Vázquez
  • Ramón Miralles
Original Article

Abstract

The incidence of sepsis is disproportionately higher in elderly adults, and age is an independent predictor of mortality. Retrospective analysis was conducted among patients admitted to the emergency department in a tertiary teaching hospital from January 2016 to June 2017. To study the prognosis determinants of sepsis among elderly patients attended in the emergency room of a tertiary care hospital. As secondary objectives, we aimed to describe the causes of sepsis, the general outcome, and the general characteristics of these patients. Two hundred thirty-five episodes data of patients admitted throughout the 15-month study period who were diagnosed with sepsis, severe sepsis or septic shock, were included. Throughout the study cohort, 51 patients (21.7%) fulfilled the criteria of severe sepsis or septic shock. All-cause mortality was 11 patients (4.7%) on day 14 and 27 (11.5%) on day 30. Prognosis factors associated with 30-day mortality were the following: albumin level < 2.6 g/dl (first quartile of the overall population), odds ratio (OR 3.26, 95% CI 12–9.41; p = 0.029), Charlson comorbidity index (OR 1.23, 95% CI 1.04–1.45; p = 0.012), C-reactive protein on admission (OR 1.04, 95% CI 0.99–1.08; p = 0.062), and non-adequacy of the initial antimicrobial therapy (OR 3.3, 95% CI 1.06–10.4; p = 0.039). Among elderly patients with sepsis, strong predictors of mortality such as albumin could be considered as part of prognosis and future potential interventions. Adequacy of antimicrobial therapy at admission must be one of the objectives in the treatment of sepsis, also in the elderly, since it is an independent predictor of mortality.

Keywords

Sepsis Albumin Mortality Elderly 

Notes

Author contributions

IAB, RGF, SL, LS, OV, and RM designed the study. IAB and RGF collected data. RGF and IAB did the statistical analysis. RGF, IAB, SL, and LS prepared the manuscript. IAB, RGF, SL, LS, OV, and RM reviewed the manuscript. Robert Güerri-Fernández is a member of the European Society of Clinical Microbiology and Infectious Diseases—Study Group for Infections in the Elderly (ESGIE) and would like to thank ESGIE members for their stimulating support to write this article

Compliance with ethical standards

This study was submitted and approved by the IRB. No informant consent was needed.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Geriatrics DepartmentBarcelonaSpain
  2. 2.Departament de MedicinaUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Infectious DiseasesHospital del Mar Medical Research Institute, IMIMBarcelonaSpain
  4. 4.PharmacyHospital del Mar Medical Research Insitute, IMIMBarcelonaSpain

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