Factor Associated with 28-Day Mortality in Elderly Patients with Sepsis
Keywords:
Sepsis, Elderly, 28-day mortalityAbstract
Sepsis remains a leading cause of mortality among older adults worldwide, largely attributable to immunosenescence and multiple chronic comorbidities. This study aimed to determine the 28-day mortality rate and identify factors associated with 28-day mortality among elderly patients hospitalized with sepsis. A retrospective study was conducted among 209 elderly patients diagnosed with sepsis using purposive sampling. Data collected included demographic characteristics, medical diagnoses, and primary sources of infection. Descriptive statistics were used to summarize the data. Differences between survivors and non-survivors were analyzed using chi-square tests. Multivariable logistic regression was performed to identify independent factors of 28-day mortality. The 28-day mortality rate was 40.2%. Although females comprised 53.6% of patients, males accounted for a greater proportion of deaths (52.4%). Septic shock occurred in 65.6% of cases and was associated with a mortality rate of 78.6%. The most common infection source was the respiratory system (50.7%), and 47.8% of patients required intensive care unit (ICU) admission. Respiratory failure (68.4%) and renal failure (52.2%) were the most frequent complications. Non-survivors had a significantly shorter hospital stay compared with survivors (8.88 vs. 17.98 days), indicating early clinical deterioration. Multivariable analysis identified malignancy as the strongest independent factor of mortality (AOR = 15.96, 95%CI = 2.68 - 94.97). Other significant factors included urinary infection (AOR = 3.29, 95%CI = 1.26 - 8.59), ICU admission (AOR = 1.35, 95%CI = 1.07 - 1.71), age (AOR = 1.05, 95%CI = 1.01 - 1.09), length of stay (AOR = 0.90, 95%CI = 0.86 - 0.95), respiratory failure (AOR = 0.38, 95%CI = 0.15 - 0.92), GI infection (AOR = 0.13, 95%CI= 0.03 - 0.58) and GI failure (AOR = 0.11, 95%CI = 0.03 - 0.40). Elderly patients with malignancy or septic shock are at markedly increased risk of early mortality. Prompt recognition and aggressive management, particularly during the first hour of admission, are critical. Implementation of elderly-focused sepsis protocols emphasizing early organ function monitoring may improve survival outcomes.
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