The purpose of this retrospective study was to evaluate risk factors of mortality in bloodstream infections in old and very old people in a French geriatric unit (Paul Brousse Hospital, APHP). 167 older patients with bloodstream infections were included and two groups were compared according to age (60-85 years and ≥85 years). Information was collected for each patient: age, sex, diseases, urinary catheter, temperature, signs of severe sepsis, biological examinations, bacteria and antibiotic treatments. All bacteremias were nosocomial. There was no difference between groups for pathogen, source or prognosis. Mortality rate at 60 days was 32.3%. The risk factors for mortality were: low albumin rate (p<0.001), high C-reactive protein (CRP) (p=0.02) and moderate fever (p=0.006). Multivariate logistic regression showed that these three parameters were significantly associated with a risk of mortality. The parameter with the highest risk was a low albumin rate <30 g/l. Malnutrition may be a more long-term risk factor. A moderate fever probably results in a more frequent delay in diagnosis in this population. Our work supports that age is not a risk factor of mortality for bloodstream infections. However management of bacteremia has to be adapted to elderly.
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http://dx.doi.org/10.1016/j.archger.2010.01.012 | DOI Listing |
Biomed Pharmacother
December 2024
Department of Research, Mount Sinai Medical Center, Miami Beach, FL, USA. Electronic address:
Background: Excessive inflammation in sepsis causes microvascular dysfunction associated with organ dysfunction and high mortality. The present studies aimed to examine the therapeutic potential of linagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor in a clinically relevant polymicrobial sepsis model in mice.
Methods: Sepsis was induced by cecal ligation and puncture (CLP).
Clin Transl Med
January 2025
Outcomes Research Consortium®, Houston, Texas, USA.
The gastrointestinal tract can be deranged by ailments including sepsis, trauma and haemorrhage. Ischaemic injury provokes a common constellation of microscopic and macroscopic changes that, together with the paradoxical exacerbation of cellular dysfunction and death following restoration of blood flow, are collectively known as ischaemia-reperfusion injury (IRI). Although much of the gastrointestinal tract is normally hypoxemic, intestinal IRI results when there is inadequate oxygen availability due to poor supply (pathological hypoxia) or abnormal tissue oxygen use and metabolism (dysoxia).
View Article and Find Full Text PDFPLoS One
December 2024
Department of Critical Care Medicine, The Second Hospital of Tianjin Medical University, Tianjin, China.
Introduction: Heparin-binding protein is an inflammatory factor with predictive value for sepsis and participates in the inflammatory response through antibacterial effects, chemotaxis, and increased vascular permeability. The role of heparin-binding protein in sepsis has been progressively demonstrated, but few studies have been conducted in the context of polytrauma combined with bacterial infections. This study aims to investigate the predictive value of heparin-binding protein for bacterial infections in patients with severe polytrauma.
View Article and Find Full Text PDFPediatr Crit Care Med
December 2024
Children's Intensive Care Research Program, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Objectives: Pediatric sepsis results in significant morbidity and mortality worldwide. There is an urgent need to investigate adjunctive therapies that can be administered early. We hypothesize that using vitamin C combined with hydrocortisone increases survival free of inotropes/vasopressors support until day 7 compared with standard care.
View Article and Find Full Text PDFAnn Med
December 2025
Department of Emergency, Changzhou No.2 People's Hospital, Changzhou City, Jiangsu Province, China.
Objective: This study aimed to investigate the prognostic impact of completing 30 mL/kg fluid resuscitation within 1 h in elderly septic shock patients.
Methods: This was a multicenter prospective observational cohort study. We applied logistic regression to assess the impact of completing 30 mL/kg fluid resuscitation within 1 h on respiratory support escalation including new-onset mechanical ventilation, bilevel positive airway pressure (BiPAP), and high-flow nasal cannula (HFNC) as well as heart failure (HF).
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