Hoffman Tomer, Margalit Ili, Tabah Alexis, Ruckly Stéphane, Barbier François, Singer Pierre, Timsit Jean-François, Prendki Virginie, Hassoun-Kheir Nasreen, Buetti Niccolò, Yahav Dafna
Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel.
Faculty of Medicine and Health Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
Infect Dis Ther. 2025 Feb;14(2):483-492. doi: 10.1007/s40121-024-01104-z. Epub 2025 Jan 11.
We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU).
We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019-2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality.
The cohort included 563 patients (median age 80, 39% women). Mortality at 28 day was 50%. Factors associated with mortality in multivariate analysis were admission due to COVID-19, failure to achieve source control, and higher SOFA. Among older adults with Gram-negative BSI, corticosteroid administration for septic shock was an additional factor. Among functionally independent patients, age itself was not associated with mortality.
HA-BSI in older adults in ICU are associated with high mortality. Inadequate source control is a significant modifiable risk factor. The use of corticosteroids in ICU management of older adults should be further investigated.
我们旨在调查重症监护病房（ICU）中年龄≥75岁的医院获得性血流感染（HA-BSI）老年患者的死亡风险因素。
我们纳入了EUROBACT-2队列（2019 - 2021年）中年龄≥75岁且在ICU发生HA-BSI的患者。进行单变量和多变量分析以确定28天死亡率的预测因素。
该队列包括563例患者（中位年龄80岁，39%为女性）。28天死亡率为50%。多变量分析中与死亡率相关的因素包括因COVID-19入院、未实现源头控制以及较高的序贯器官衰竭评估（SOFA）评分。在革兰阴性菌血流感染的老年患者中，因感染性休克使用皮质类固醇是另一个因素。在功能独立的患者中，年龄本身与死亡率无关。
ICU中老年人的HA-BSI与高死亡率相关。源头控制不足是一个重要的可改变风险因素。在ICU中对老年人使用皮质类固醇的情况应进一步研究。
