Deaths among the elderly with ICU infections

to evaluate the clinical outcome of elderly patients admitted to intensive care units who had nosocomial infection, correlating the findings with sociodemographic and clinical variables.

Method:

descriptive research, performed with 308 elderly patients. The collection was made from medical records and covers the years 2012 to 2015. Uni-/bivariate analyses were performed.

Results:

a statistical association was found between the clinical outcome types and the variables age, length of stay, presence of previous comorbidities, main diagnosis, respiratory and urinary tract infections, use of central venous and indwelling urinary catheters, mechanical ventilation, and tracheostomy. The survival curve showed higher mortality among the elderly from the age of 80 on.

Conclusion:

the clinical outcome of the elderly who acquire infection in the intensive care unit is influenced by sociodemographic and clinical variables that increase mortality rates.

Descriptors:
Infection; Elderly; Clinical Outcome; Death; Intensive Care Units

	Clinical outcome								p value^* * Statistical significance was set at p ≤ 0.05;
	Improved		Transference		Death		Total
	n	%	n	%	n	%	n	%
Total	120	39.0	31	10.1	157	50.9	308	100.0
Gender									0.233
Male	55	43.3	11	8.7	61	48.0	127	41.2
Female	65	36.0	20	11.0	96	53.0	181	58.8
Age range									0.045
60 to 69 years	67	43.0	16	10.2	73	46.8	156	50.6
70 to 79 years	39	41.0	9	9.5	47	49.5	95	30.9
80 years on	14	24.6	6	10.5	37	64.9	57	18.5
Time of stay									< 0.001
1-10 days	62	44.6	4	2.9	73	52.5	139	45.2
11-20 days	20	26.7	18	24	37	49.3	75	24.3
21-30 days	18	40.9	6	13.6	20	45.5	44	14.3
31-40 days	5	16.7	3	10.0	22	73.3	30	9.7
41 or more days	15	75.0	0	0	5.0	25.0	20	6.5
Associated comorbidities ^ It does not sum 100%, because patients could have more than one associated comorbidity.									0.003
Hypertension	42	40.8	8	7.8	53	51.4	103	33.4
Diabetes	14	32.5	11	25.6	18	41.9	43	14.0
Chronic renal insufficiency	24	34.3	13	18.6	33	47.1	70	22.7
Cardiopathies	13	35.1	7	18.9	17	46.0	37	12.0
Obesity	12	46.1	6	23.1	8	30.8	26	8.4
Others	25	44.6	4	7.1	27	48.3	56	18.1
Main diagnosis									0.001
Limb fracture	41	32.6	12	9.5	73	57.9	126	40.9
Neoplasias	22	50.0	7	15.9	15	34.0	44	14.3
Treatment of liver diseases	19	41.3	10	21.7	17	37.0	46	14.9
Treatment of cardiovascular diseases	14	30.4	3	6.5	29	63.1	46	14.9
Treatment of neurological diseases	7	33.3	2	9.5	12	57.2	21	6.8
Treatment of respiratory diseases	14	56.0	1	4.0	10	40.0	25	8.2

Topography	Clinical outcome
	Improved		Transference		Death		Total		p value^* * Statistical significance was set at p ≤ 0.05;
	n	%	n	%	n	%	n	%
Total	120	39.0	31	10.0	157	51.0	308	100
Respiratory tract infection									0.002
Yes	49	32.0	16	10.5	88	57.5	153	49.7
No	71	45.8	15	9.7	69	44.5	155	50.3
Urinary tract infection									0.045
Yes	48	46.1	6	5.8	50	48.1	104	33.8
No	72	35.3	25	12.3	107	52.4	204	66.2
Bloodstream Infection									0.298
Yes	30	32.3	12	10.7	47	57.0	89	21.1
No	90	40.7	19	9.9	110	49.4	219	78.9
Surgical site infection									1.000^ Fischer's exact test.
Yes	6	40.0	1	6.7	8	53.3	15	4.9
No	114	38.9	30	10.2	149	50.9	293	95.1

Use of invasive procedures	Clinical outcome
	Improved		Transference		Death		Total		p value^* * Statistical significance was set at p ≤0.05.
	n	%	n	%	n	%	n	%
Total	120	39.0	31	10.0	157	51.0	308	100
Nasogastric/nasoenteral tube									0.290
Yes	70	38.0	15	8.2	99	53.8	184	59.7
No	50	40.3	16	12.9	58	46.8	124	40.3
Indwelling vesical catheter									< 0.001
Yes	83	32.8	23	9.1	147	58.1	253	82.1
No	37	67.3	8	14.5	10	18.2	55	17.9
Endotracheal tube									0.001
Yes	80	52.3	14	9.1	59	38.6	153	49.7
No	68	43.9	17	11.0	70	45.1	155	50.3
Tracheostomy									0.001
Yes	33	27.3	18	14.9	70	57.8	121	39.3
No	87	46.5	13	7.0	87	46.5	187	60.7
Ventral venous access									0.007
Yes	43	53.7	7	8.8	30	37.5	80	26.0
No	77	33.8	25	11.0	126	55.2	228	74.0

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[1] CORRESPONDING AUTHOR: Alvaro Francisco Lopes de Sousa. Email: alvarosousa@usp.br