Septicemia in the elderly: incidence, etiology and prognostic factors

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.