Journal article
Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study
Infection, Vol.52(6), pp.2435-2443
12/01/2024
DOI: 10.1007/s15010-024-02304-y
PMCID: PMC11621140
PMID: 38869773
Abstract
Purpose Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (>= 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI).
Methods Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (>= 18 years) hospitalized in the ICU during 2019-2021. We compared older versus younger adults in terms of infection characteristics (clinical signs and symptoms, source, and microbiological data), management (imaging, source control, antimicrobial therapy), and outcomes (28-day mortality and hospital discharge).
Results Among 2111 individuals hospitalized in 219 ICUs with HA-BSI, 563 (27%) were >= 75 years old. Compared to younger patients, these individuals had higher comorbidity score and lower functional capacity; presented more often with a pulmonary, urinary, or unknown HA-BSI source; and had lower heart rate, blood pressure and temperature at presentation. Pathogens and resistance rates were similar in both groups. Differences in management included mainly lower rates of effective source control achievement among aged individuals. Older adults also had significantly higher day-28 mortality (50% versus 34%, p<0.001), and lower rates of discharge from hospital (12% versus 20%, p<0.001) by this time.
Conclusions Older adults with HA-BSI hospitalized in ICU have different baseline characteristics and source of infection compared to younger patients. Management of older adults differs mainly by lower probability to achieve source control. This should be targeted to improve outcomes among older ICU patients.
Details
- Title: Subtitle
- Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study
- Creators
- Ili Margalit - Sheba Medical CenterDafna Yahav - Sheba Medical CenterTomer Hoffman - Sheba Medical CenterAlexis Tabah - The University of QueenslandStephane Ruckly - Université Paris CitéFrancois Barbier - Centre hospitalier universitaire d'OrléansPierre Singer - Tel Aviv UniversityJean-Francois Timsit - Université Paris CitéVirginie Prendki - University Hospital of GenevaNiccolo Buetti - Université Paris CitéEUROBACT-2 Study GroupEuropean Society of Intensive Care Medicine (ESICM)European Society of Clinical Microbiology and Infectious Diseases (ESCMID)ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP)ESCMID Study Group for Infections in the Elderly (ESGIE)OUTCOMEREA NetworkOlusola A Idowu (Contributor) - Anesthesia
- Resource Type
- Journal article
- Publication Details
- Infection, Vol.52(6), pp.2435-2443
- DOI
- 10.1007/s15010-024-02304-y
- PMID
- 38869773
- PMCID
- PMC11621140
- NLM abbreviation
- Infection
- ISSN
- 0300-8126
- eISSN
- 1439-0973
- Publisher
- Springer Nature
- Number of pages
- 9
- Grant note
- Tel Aviv University European Society of Intensive Care Medicine (ESICM) European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study Group for Infections in Critically Ill Patients (ESGCIP) Norva Dahlia foundation Redcliffe Hospital Private Practice Trust Fund
- Language
- English
- Date published
- 12/01/2024
- Academic Unit
- Anesthesia
- Record Identifier
- 9984787257702771
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