Age-related differences in sepsis outcomes: A comparative analysis of elderly and very elderly ICU patients
By: Ozgur Kilic and Enver Demircan
References
- Hillman K, Athari F, Frost S, Braithwaite J. Australia: The silver tsunami: The impact of the aging population on healthcare. In: Braithwaite J, Mannion R, Matsuyama Y, Shekelle PG, Whittaker S, Al-Adawi S, editors. Healthcare systems: Future predictions for global care. CRC Press; 2018. p. 367–372.
- Hotchkiss R, Moldawer L, Opal S, Reinhart K, Turnbull I, Vincent JL. Sepsis and septic shock. Nat Rev Dis Primers. 2016;2:16045.
- Martín S, Pérez A, Aldecoa C. Sepsis and immunosenescence in the elderly patient: A review. Front Med (Lausanne). 2017;4:20.
- De Gaudio AD, Rinaldi S, Chelazzi C, Borracci T. Pathophysiology of sepsis in the elderly: Clinical impact and therapeutic considerations. Curr Drug Targets. 2009;10(1):60–70.
- Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al. Sepsis and organ dysfunction in the elderly: Insights from the Sepsis-3 definitions. Intensive Care Med. 2021;47(3):228–240.
- Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.
- Pauley E, Walsh T. Resilience in survivors of critical illness: A scoping review of the published literature in relation to definitions, prevalence, and relationship to clinical outcomes. J Intensive Care Soc. 2021;23:345–358.
- Charlson M, Carrozzino D, Guidi J, Patierno C. Charlson Comorbidity Index: A critical review of clinimetric properties. Psychother Psychosom. 2022;91:8–35.
- Vansteelandt S, Walter S, Tchetgen E. Eliminating survivor bias in two-stage instrumental variable estimators. Epidemiology. 2018;29:536–541.
- Kosyakovsky L, Angriman F, Katz E, Adhikari N, Godoy L, Marshall J, et al. Association between sepsis survivorship and long-term cardiovascular outcomes in adults: A systematic review and meta-analysis. Intensive Care Med. 2021;47:931–942.
- El-Jawahri A, Leblanc T, Kavanaugh A, Webb J, Jackson V, Campbell T, et al. Effectiveness of integrated palliative and oncology care for patients with acute myeloid leukemia: A randomized clinical trial. JAMA Oncol. 2020.
- Obama K, Fujimori M, Okamura M, Kadowaki M, Ueno T, Boku N, et al. Protocol of a randomized controlled trial evaluating a program facilitating empathetic communication for initiating advanced care planning discussions between patients with advanced cancer and healthcare providers (J-SUPPORT 2104). medRxiv. 2022.
- Maltoni M, Scarpi E, Dall’agata M, Schiavon S, Biasini C, Codecà C, et al. Systematic versus on-demand early palliative care: A randomised clinical trial assessing quality of care and treatment aggressiveness near the end of life. Eur J Cancer. 2016;69:110–118.
- Lee S, Koh Y, Huh J, Hong S, Lim C. Factors and outcomes of intensive care unit readmission in elderly patients. Gerontology. 2021;68:280–288.
- Moitra V, Guerra C, Linde-Zwirble W, Wunsch H. Relationship between ICU length of stay and long-term mortality for elderly ICU survivors. Crit Care Med. 2015;44:655–662.
- Almashrafi A, Elmontsri M, Aylin P. Systematic review of factors influencing length of stay in ICU after adult cardiac surgery. BMC Health Serv Res. 2016;16.
- Torres VB, Azevedo L, Silva UV, Caruso P, Torelly A, Silva E, et al. Sepsis-associated outcomes in critically ill patients with malignancies. Ann Am Thorac Soc. 2015;12(8):1185–1192.
- Lemiale V, Pons S, Mirouse A, Tudesq J, Hourmant Y, Mokart D, et al. Sepsis and septic shock in patients with malignancies: A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique study. Crit Care Med. 2020;48:822–829.
- Pinzone M, Berretta M, Doerr H, Nunnari G, Cacopardo B. The complexity of aging: Cancer risk among elderly people and infectious risk among those with cancer. Anticancer Agents Med Chem. 2013;13(9):1444–1448.
- Freifeld A, Kaul D. Infection in the patient with cancer. Infect Dis Clin North Am. Elsevier; 2013. p. 649–666.
- Gudiol C, Albasanz-Puig A, Cuervo G, Carratalá J. Understanding and managing sepsis in patients with cancer in the era of antimicrobial resistance. Front Med. 2021;8.
- Venet F, Monneret G. Advances in the understanding and treatment of sepsis-induced immunosuppression. Nat Rev Nephrol. 2018;14:121–137.
- Murlidharan A, Dhar M, Pathania M, Agarwal M, Sethi P, Saxena V, et al. Predictive value of frailty index in comparison to traditional markers of sepsis in predicting mortality among elderly admitted in tertiary care hospital. J Assoc Physicians India. 2022;70(9):11–12.
- Fernando S, McIsaac D, Perry J, Rochwerg B, Bagshaw S, Thavorn K, et al. Frailty and associated outcomes and resource utilization among older ICU patients with suspected infection. Crit Care Med. 2019;47:822–829.
- Wernly B, Fjølner J, Flaatten H, Bruno RR, Artigas A, Bollen Pinto B, et al. The impact of comorbidities and frailty on outcomes of elderly ICU patients with sepsis: A prospective multicenter study. J Crit Care. 2022;68:154069.
- Amer MS, Mabrouk R, Farid T, Khater M, Alakad R, Goda M. Serum lactate and outcome in critically ill elderly admitted to ICU. Indian J Appl Res. 2016;6.
- Bruno R, Wernly B, Flaatten H, Fjolner J, Artigas A, Bollen Pinto B, et al. Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: Results from an international observational study. Ann Intensive Care. 2021;11.
- Tekin B, Kılıç J, Taskin G, Solmaz I, Tezel O, Başgöz B. The comparison of scoring systems: SOFA, APACHE-II, LODS, MODS, and SAPS-II in critically ill elderly sepsis patients. J Infect Dev Ctries. 2024;18(1):122–130.
- Qiao Q, Lu G, Li M, Shen Y, Xu D. Prediction of outcome in critically ill elderly patients using APACHE II and SOFA scores. J Int Med Res. 2012;40(3):1114–1121.
- Niederman M, Baron R, Bouadma L, Calandra T, Daneman N, Dewaele J, et al. Initial antimicrobial management of sepsis. Crit Care. 2021;25:118.
- Kullberg BJ, Arendrup MC. Invasive candidiasis. N Engl J Med. 2015;373(15):1445–1456.
- Clancy CJ, Nguyen MH. Diagnosing invasive candidiasis. J Clin Microbiol. 2018;56(5):e01909–17.
- Esteban A, Anzueto A, Frutos-Vivar F, Alia I, Ely EW, Brochard L, et al. Outcome of older patients receiving mechanical ventilation. Intensive Care Med. 2004;30(4):639–646.
- Jiang W, Zhang C, Yu J, Shao J, Zheng R. Development and validation of a nomogram for predicting in-hospital mortality of elderly patients with persistent sepsis-associated acute kidney injury in intensive care units: A retrospective cohort study using the MIMIC-IV database. BMJ Open. 2023;13.
- Gameiro J, Carreiro C, Fonseca J, Pereira M, Jorge S, Gouveia J, Lopes J. Acute kidney disease and long-term outcomes in critically ill acute kidney injury patients with sepsis: A cohort analysis. Clin Kidney J. 2020;14:1379–1387.
Language: English
Page range: 337 - 346
Submitted on: Dec 25, 2024
Accepted on: Jul 17, 2025
Published on: Oct 31, 2025
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
Related subjects:
© 2025 Ozgur Kilic, Enver Demircan, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.