. 2019 Jul 2;8(7):961.

doi: 10.3390/jcm8070961.

Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia

Catia Cillóniz^{1

2

3}, Cristina Dominedò⁴, Antonella Ielpo⁵, Miquel Ferrer^{6

7

8}, Albert Gabarrús^{6

7

8}, Denise Battaglini⁹, Jesús Bermejo-Martin¹⁰, Andrea Meli¹¹, Carolina García-Vidal¹², Adamanthia Liapikou¹³, Mervyn Singer¹⁴, Antoni Torres^{15

16

17}

Affiliations

¹ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. catiacilloniz@yahoo.com.
² August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain. catiacilloniz@yahoo.com.
³ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain. catiacilloniz@yahoo.com.
⁴ Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
⁵ Departments of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, 43121 Parma, Italy.
⁶ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
⁷ August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
⁸ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain.
⁹ Department of Surgical Sciences and Integrated Diagnostic, Policlinico San Martino, University of Genova, 16126 Genova, Italy.
¹⁰ Group for Biomedical Research in Sepsis (Bio Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
¹¹ Department of Anesthesia and Intensive Care, University of Milan, 20122 Milan, Italy.
¹² Infectious Diseases Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
¹³ Respiratory Department, Sotiria Chest Diseases Hospital, Mesogion 152, 11527Athens, Greece.
¹⁴ Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Cruciform Building, Gower St, London WC1E 6BT, UK.
¹⁵ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. atorres@clinic.cat.
¹⁶ August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain. atorres@clinic.cat.
¹⁷ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain. atorres@clinic.cat.

PMID: 31269766
PMCID: PMC6678833
DOI: 10.3390/jcm8070961

Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia

Catia Cillóniz et al. J Clin Med. 2019.

. 2019 Jul 2;8(7):961.

doi: 10.3390/jcm8070961.

Authors

Affiliations

¹ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. catiacilloniz@yahoo.com.
² August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain. catiacilloniz@yahoo.com.
³ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain. catiacilloniz@yahoo.com.
⁴ Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
⁵ Departments of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, 43121 Parma, Italy.
⁶ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
⁷ August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
⁸ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain.
⁹ Department of Surgical Sciences and Integrated Diagnostic, Policlinico San Martino, University of Genova, 16126 Genova, Italy.
¹⁰ Group for Biomedical Research in Sepsis (Bio Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
¹¹ Department of Anesthesia and Intensive Care, University of Milan, 20122 Milan, Italy.
¹² Infectious Diseases Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
¹³ Respiratory Department, Sotiria Chest Diseases Hospital, Mesogion 152, 11527Athens, Greece.
¹⁴ Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Cruciform Building, Gower St, London WC1E 6BT, UK.
¹⁵ Department of Pneumology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain. atorres@clinic.cat.
¹⁶ August Pi i Sunyer Biomedical Research Institute-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain. atorres@clinic.cat.
¹⁷ Biomedical Research Networking Centres in Respiratory Diseases (Ciberes), 28029 Madrid, Spain. atorres@clinic.cat.

PMID: 31269766
PMCID: PMC6678833
DOI: 10.3390/jcm8070961

Abstract

Little is known about risk and prognostic factors in very old patients developing sepsis secondary to community-acquired pneumonia (CAP). Methods: We conducted a retrospective observational study of data prospectively collected at the Hospital Clinic of Barcelona over a 13-year period. Consecutive patients hospitalized with CAP were included if they were very old (≥80 years) and divided into those with and without sepsis for comparison. Sepsis was diagnosed based on the Sepsis-3 criteria. The main clinical outcome was 30-day mortality. Results: Among the 4219 patients hospitalized with CAP during the study period, 1238 (29%) were very old. The prevalence of sepsis in this age group was 71%. Male sex, chronic renal disease, and diabetes mellitus were independent risk factors for sepsis, while antibiotic therapy before admission was independently associated with a lower risk of sepsis. Thirty-day and intensive care unit (ICU) mortality did not differ between patients with and without sepsis. In CAP-sepsis group, chronic renal disease and neurological disease were independent risk factors for 30-day mortality. Conclusion: In very old patients hospitalized with CAP, in-hospital and 1-year mortality rates were increased if they developed sepsis. Antibiotic therapy before hospital admission was associated with a lower risk of sepsis.

Keywords: community-acquired pneumonia; pneumonia; sepsis; very old.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Flow chart of the study population.

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Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia

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Risk and Prognostic Factors in Very Old Patients with Sepsis Secondary to Community-Acquired Pneumonia

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