Septicemia in the elderly.

ABSTRACT

The epidemiologic study regarding septicemia in the elderly was done in general medical wards and intensive care units of Department of Medicine, Siriraj Hospital. The average age of the 100 patients recruited was 70.6 + 8.2 years old with the prevalence of community-acquired septicemia and nosocomial septicemia being 52% and 48% respectively. Sex, the ratio of infection from gram-negative and gram-positive organisms and the mortality rate were not significantly different between those two groups of patients. Gram-negative septicemia constituted 70% of all infections i.e. 2-2.5 time of gram-positive septicemia. The most frequent causative organisms were E. coli (19%) and nonfermentative gram-negative rod (18-%) whereas Staphylococcus aureus was found in greatest number among gram-positive organisms (10%). The mortality rate of septicemia was 49% but only 28% could be discharged alive due to the fact that another 23% of the patients died from other causes such as from the complications of their own underlying diseases as only 2% had no any underlying disease. Cirrhosis was found to be the most serious underlying disease with the mortality rate of 1%. The most common identified site of infection was urinary tract infection (16%), however, intravascular catheter was responsible for nosocomial septicemia in the greatest extent. Serum albumin nonspecific prognostic in elderly patients with the average value of 3.01 + 0.78 gm% among the survivors and 2.55 + 0.97 gm% among the victims. Multiple logistic regression analysis showed that septic shock, hypothermia and consciousness were the independent risk factors of the mortality rate of septicemia in the elderly.