Infection, sepsis, and immune function in the older adult receiving critical care

The elderly are vulnerable to developing sepsis due to functional and immune changes, and frequent instrumentation and contact with the health care system. Those infected often present with nonspecific complaints and are at risk for underrecognition and undertreatment, with greater likelihood of rapid progression to severe sepsis and septic shock; however, often respond well to early, organized, and aggressive interventions. Survivors may not return to baseline level of function and may require long-term care facilities after discharge from the hospital. Patient and family preferences for goals of care should be explored as early as possible and incorporated into treatment plans.