Roux Xavier, Huttner Benedikt, Pugin Jérôme, Prendki Virginie, Reny Jean-Luc
Service de médecine interne et réhabilitation, Département de médecine interne, réhabilitation et gériatrie, site des Trois-Chêne, HUG, 1211 Genève 14.
Service des maladies infectieuses, Département des spécialités médicales, HUG, 1211 Genève 14.
Rev Med Suisse. 2016 Nov 9;12(538):1917-1921.
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection. The clinical presentation of sepsis in the elderly is very variable and sepsis is therefore challenging to diagnose in this population. The new sepsis definitions published in 2016, which are based on objective clinical and biological scores, should lead to earlier recognition and diagnosis. Treatment should start as soon as possible because the specific pathophysiological changes of aging increase the risk of a sudden deterioration to septic shock. Physicians should treat elderly patients with sepsis according to internationally recommended guidelines but should take into account specific aspects related to the elderly. These aspects include the presence of specific comorbidities and the need to clarify the overall objectives of care when deciding to admit a patient to the intensive care unit.
脓毒症被定义为由宿主对感染的失调反应引起的危及生命的器官功能障碍。老年人脓毒症的临床表现差异很大，因此在这一人群中诊断脓毒症具有挑战性。2016年发布的新脓毒症定义基于客观的临床和生物学评分，应能实现更早的识别和诊断。由于衰老的特定病理生理变化会增加突然恶化为感染性休克的风险，治疗应尽早开始。医生应根据国际推荐指南治疗老年脓毒症患者，但应考虑与老年人相关的特定方面。这些方面包括特定合并症的存在，以及在决定将患者收入重症监护病房时明确总体护理目标的必要性。
