Volume 13 Supplement 3

Fifth International Symposium on Intensive Care and Emergency Medicine for Latin America

Open Access

Prognosis scores on septic shock and severe sepsis in older people

  • RL Machado1,
  • R Bak1,
  • A Bicudo1,
  • CMN David1,
  • RR Luiz1,
  • GMM Oliveira1 and
  • C Salomão1
Critical Care200913(Suppl 3):P17

https://doi.org/10.1186/cc7819

Published: 23 June 2009

Introduction

The elements related to prognosis of older people admitted to hospital on severe sepsis and septic shock are not yet well settled.

Objective

To impute a prognostic score for older people admitted to hospital on severe sepsis and septic shock considering the death rate within 28 days.

Materials and methods

The follow-up of 152 patients aged ≥ 65, admitted to the ICU, for severe sepsis/septic shock during 28 days. The APACHE II and the Lawton dependence scales were applied on the first day while the SOFA was applied on days 1, 3, 5, and 7. Regarding statistical analysis, the chi-squared test and the Student t test were used. It was considered relevant when P < 0.05.

Results

Age varied from 65 to 102 years (82 ± 9 years), with 64.5% women. The global mortality was 47.4%, in which 93.1% of deceased patients had been diagnosed with septic shock. The APACHE II and SOFA averages on days 1, 3, 5, and 7 were higher for the nonsurvivors, as well as the ΔSOFA 3 – 1 and 5 – 3 (Table 1). Patients with limited functional capacity measured by the Lawton scale had higher chance of dying (OR = 0.5, 95% CI = 0.26 to 0.98, P = 0.04).
Table 1

abstract

Score

Survivors

Nonsurvivors

P value

APACHE II

17.29 ± 4.78 (80)

20.61 ± 6.52 (72)

<0.001

SOFA 1

6.04 ± 3.27 (80)

8.56 ± 3.19 (72)

<0.001

SOFA 3

5.04 ± 3.06 (80)

9.25 ± 4.08 (69)

<0.001

SOFA 5

4.37 ± 2.89 (73)

8.67 ± 3.41 (57)

<0.001

SOFA 7

4.12 ± 2.75 (67)

8.34 ± 3.65 (53)

<0.001

ΔSOFA 3 – 1

-1.0 ± 2.00 (80)

0.42 ± 2.37 (69)

<0.001

ΔSOFA 5 – 3

-0.91 ± 2.22 (73)

0.17 ± 1.95 (57)

<0.01

Data presented as average ± SD (n).

Conclusion

The prognosis scores APACHE II and SOFA and the Lawton scale can be applicable to the older population with septic shock/severe sepsis, properly distinguishing survivors from non-survivors.

Authors’ Affiliations

(1)
Prontocor Universidade Federal do Rio de Janeiro

Copyright

© BioMed Central Ltd 2009

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