Sonnenblick M, Carmon M, Rudenski B, Friedlander Y, Van Dijk J M
Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel.
Isr J Med Sci. 1990 Apr;26(4):195-9.
A study on septicemia in the elderly (mean age 80.3 +/- 9.1 years) was carried out during 1982-85. A total of 184 episodes of bacteremia occurred in 175 patients (incidence rate 7.2%); 61% were attributed to community-acquired sepsis. Gram-negative microorganisms accounted for 64% of all episodes and gram-positive for 30%. The overall mortality was 18.3%. Using univariate analysis, significant factors associated with a high mortality were: hospital-acquired sepsis, respiratory infections as source of the sepsis, severe underlying disease, Klebsiella and Proteus as pathogens, comatose state, hypothermia, thrombocytopenia, and serum sodium abnormalities. Using logistic regression analysis the odds ratio for hospital-acquired septicemia and hypothermia were positive and statistically significant, whereas soft tissue and urinary tract infections as sources were negative and significant. The relative low mortality in our study confirms that age alone is not necessarily a poor prognostic indicator of septicemia in the elderly.
1982年至1985年期间，对老年人（平均年龄80.3±9.1岁）的败血症进行了一项研究。175名患者共发生184次菌血症发作（发病率7.2%）；61%归因于社区获得性败血症。革兰氏阴性微生物占所有发作的64%，革兰氏阳性微生物占30%。总死亡率为18.3%。采用单因素分析，与高死亡率相关的显著因素有：医院获得性败血症、作为败血症来源的呼吸道感染、严重基础疾病、肺炎克雷伯菌和变形杆菌作为病原体、昏迷状态、体温过低、血小板减少和血清钠异常。使用逻辑回归分析，医院获得性败血症和体温过低的优势比为阳性且具有统计学意义，而作为来源的软组织和尿路感染则为阴性且具有统计学意义。我们研究中相对较低的死亡率证实，年龄本身不一定是老年人败血症预后不良的指标。
