Factors associated with mortality in older sepsis patients: a nationwide retrospective cohort study in Germany.
Background Sepsis is a leading cause of mortality in older adults, but large unselected cohort data on factors associated with mortality remain limited. Objective To examine patient characteristics and acute illness features associated with mortality among older patients hospitalised with sepsis in...
| Publicado en: | Age & Ageing Vol. 55; no. 7; pp. 1 - 12 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jul2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195867355&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195867355 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2026 vid: 55 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195867355 10.1093/ageing/afag200 ppf: 1 ppct: 11 formats: tig: atl: Factors associated with mortality in older sepsis patients: a nationwide retrospective cohort study in Germany. aug: au: Heimrich, Konstantin G Prell, Tino Rose, Norman Schönenberg, Aline Pletz, Mathias W Ruhnke, Thomas Fleischmann-Struzek, Carolin affil: Department of Geriatrics, Jena University Hospital, Jena, Germany Institute of Infectious Diseases and Infectious Control, Jena University Hospital, Jena, Germany Wissenschaftliches Institut der AOK, Berlin, Germany su: Germany Sex distribution Retrospective studies Sociodemographic factors Hospital care of older people Critical care medicine AIDS Old age Mortality prevention Mortality risk factors Risk assessment Mathematical variables Acute diseases Research funding T-test (Statistics) Scientific observation Multiple regression analysis Multiple organ failure Frail elderly Questionnaires Hospital mortality Symptoms Discharge planning Hemodialysis Chi-squared test Descriptive statistics Polypharmacy Severity of illness index HIV infections Longitudinal method Metastasis Odds ratio Liver diseases Sepsis Medical records Acquisition of data Research Artificial respiration Statistics Liver Survival analysis (Biometry) Individualized medicine Data analysis software Comparative studies Kidneys sug: subj: Sex distribution Retrospective studies Sociodemographic factors Hospital care of older people Critical care medicine AIDS Old age Germany Kidney Dialysis Centers Mortality prevention Mortality risk factors Risk assessment Mathematical variables Acute diseases Research funding T-test (Statistics) Scientific observation Multiple regression analysis Multiple organ failure Frail elderly Questionnaires Hospital mortality Symptoms Discharge planning Hemodialysis Chi-squared test Descriptive statistics Polypharmacy Severity of illness index HIV infections Longitudinal method Metastasis Odds ratio Liver diseases Sepsis Medical records Acquisition of data Research Artificial respiration Statistics Liver Survival analysis (Biometry) Individualized medicine Data analysis software Comparative studies Kidneys keyword: aged copyrightHolder:British Geriatrics Society copyrightYear:2026 critical care dialysis procedure germany hemodialysis hospital mortality https://dx.doi.org/10.1093/ageing/afag200 individualised medicine inLanguage:en intensive care mortality older people organ failure publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42407093/ sepsis aged copyrightHolder:British Geriatrics Society copyrightYear:2026 critical care dialysis procedure germany hemodialysis hospital mortality https://dx.doi.org/10.1093/ageing/afag200 individualised medicine inLanguage:en intensive care mortality older people organ failure publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42407093/ sepsis ab: Background Sepsis is a leading cause of mortality in older adults, but large unselected cohort data on factors associated with mortality remain limited. Objective To examine patient characteristics and acute illness features associated with mortality among older patients hospitalised with sepsis in Germany. Methods We conducted a retrospective, observational cohort study using statutory health insurance data (AOK) of patients aged ≥70 years and hospitalised with sepsis between 2016 and 2019. Outcomes were in-hospital and 90-day post-discharge mortality. Multivariate blockwise logistic regression models were applied to examine associations across conceptual domains. Results Of 227 110 older sepsis patients [median age, 81 years (IQR 76–85); 49.2% women], in-hospital mortality was 35.2%. Organ dysfunction, particularly hepatic and renal dysfunction, as well as receipt of organ support including mechanical ventilation and dialysis, showed strong associations with in-hospital mortality. Among 147 080 patients discharged alive, 19.5% died within 90 days. In this post-discharge phase, care dependency and metastatic cancer showed stronger associations with mortality, whereas associations with acute illness features were lower. Female sex was independently associated with lower mortality and conferred a survival advantage after discharge. Conclusion The high mortality rate of older sepsis patients is associated with both baseline patient vulnerability and acute illness severity. Care dependency, used as a proxy for functional vulnerability overlapping with frailty, showed a strong association with mortality, particularly after discharge. These findings highlight the importance of integrating preexisting patient vulnerability and acute illness characteristics to guide individualised acute and post-discharge care for older sepsis patients. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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