Palomba Henrique, Corrêa Thiago Domingos, Silva Eliézer, Pardini Andreia, Assuncao Murillo Santucci Cesar de
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2015 Jul-Sep;13(3):357-63. doi: 10.1590/S1679-45082015AO3313. Epub 2015 Aug 21.
To compare outcomes between elderly (≥65 years old) and non-elderly (<65 years old) resuscitated severe sepsis and septic shock patients and determine predictors of death among elderly patients.
Retrospective cohort study including 848 severe sepsis and septic shock patients admitted to the intensive care unit between January 2006 and March 2012.
Elderly patients accounted for 62.6% (531/848) and non-elderly patients for 37.4% (317/848). Elderly patients had a higher APACHE II score [22 (18-28)versus 19 (15-24); p<0.001], compared to non-elderly patients, although the number of organ dysfunctions did not differ between the groups. No significant differences were found in 28-day and in-hospital mortality rates between elderly and non-elderly patients. The length of hospital stay was higher in elderly compared to non-elderly patients admitted with severe sepsis and septic shock [18 (10-41)versus 14 (8-29) days, respectively; p=0.0001]. Predictors of death among elderly patients included age, site of diagnosis, APACHE II score, need for mechanical ventilation and vasopressors.
In this study population early resuscitation of elderly patients was not associated with increased in-hospital mortality. Prospective studies addressing the long-term impact on functional status and quality of life are necessary.
比较老年（≥65岁）与非老年（<65岁）复苏的严重脓毒症和脓毒性休克患者的预后，并确定老年患者的死亡预测因素。
回顾性队列研究，纳入2006年1月至2012年3月间入住重症监护病房的848例严重脓毒症和脓毒性休克患者。
老年患者占62.6%（531/848），非老年患者占37.4%（317/848）。与非老年患者相比，老年患者的急性生理与慢性健康状况评分系统（APACHE）II评分更高[22（18 - 28）对19（15 - 24）；p<0.001]，尽管两组间器官功能障碍的数量无差异。老年与非老年患者的28天和住院死亡率无显著差异。与因严重脓毒症和脓毒性休克入院的非老年患者相比，老年患者的住院时间更长[分别为18（10 - 41）天对14（8 - 29）天；p = 0.0001]。老年患者的死亡预测因素包括年龄、诊断部位、APACHE II评分、机械通气需求和血管升压药需求。
在本研究人群中，老年患者的早期复苏与住院死亡率增加无关。有必要进行前瞻性研究以探讨对功能状态和生活质量的长期影响。
