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. 2019 Apr;34(4):292-300.
doi: 10.1177/0885066617715251. Epub 2017 Jul 5.

Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort

Mythreyi Mahalingam  1 , Justin Xavier Moore  2   3 , John P Donnelly  2   3   4 , Monika M Safford  4   5 , Henry E Wang  1
Affiliations

Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort

Mythreyi Mahalingam et al. J Intensive Care Med. 2019 Apr.

Abstract

Background:: Frailty is associated with increased morbidity and mortality in older persons. We sought to characterize the associations between the frailty syndrome and long-term risk of sepsis in a large cohort of community-dwelling adults.

Methods:: We analyzed data on 30 239 community-dwelling adult participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We defined frailty as the presence of at least 2 frailty indicators (weakness, exhaustion, and low physical activity). We defined sepsis as hospitalization for a serious infection with ≥2 system inflammatory response syndrome criteria, identified for the period 2003-2012. We determined the associations between frailty and risk of first sepsis and sepsis 30-day case fatality.

Results:: Among REGARDS participants, frailty was present in 6018 (19.9%). Over the 10-year observation period, there were 1529 first-sepsis hospitalizations. Frailty was associated with increased risk of sepsis (adjusted hazard ratio [HR] 1.44; 95% CI: 1.26 to 1.64). The total number of frailty indicators was associated with increased risk of sepsis ( P trend <.001). Among first-sepsis hospitalizations, frailty was associated with increased sepsis 30-day case fatality (adjusted OR 1.62; 95% CI: 1.06 to 2.50).

Conclusions:: In the REGARDS cohort, frailty was associated with increased long-term risk of sepsis and sepsis 30-day case fatality.

Keywords: epidemiology; frailty; infection; sepsis.

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Conflict of interest statement

Declaration of Conflicting Interests

Ms. Mahalingam, Mr. Moore, Mr. Donnelly, and Dr. Wang do not report any related conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier graph for first sepsis events, stratified by frailty status.
See this image and copyright information in PMC

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