Bacteraemia in the elderly: predictors of outcome in an urban teaching hospital

To analyze the underlying factors of mortality in elderly adults with bacteraemia.

The study included 238 episodes of bacteraemia in an urban public teaching hospital. Retrospective chart review recorded demographic information, comorbid conditions, length of stay, source of infection, and physiologic and laboratory data on admission.

Of the 238 episodes of bacteraemia, 128 patients were 65-74 years of age and 110 patients were > or =75 years of age. Eighty-one percent came from home. Fifty-four percent had Gram positive cocci detected in blood cultures and 36% had Gram negative bacilli. Factors associated with increased odds of mortality included underlying renal disease, admission to MICU, hypotension and hypoalbuminemia. Decreased odds of mortality were associated with being admitted from home and receiving appropriate antibiotics.

Bacteraemia in the elderly has a high mortality rate, but is not significantly increased in those >or =75 years of age. The recent microbiology has shifted from Gram negative bacilli to Gram positive cocci. Physiologic abnormalities on admission predict worse outcomes in the elderly bacteraemic patient. Hypoalbuminemia on admission is associated with higher mortality rates in the elderly.