Age may not influence the outcome of patients with severe sepsis in intensive care units

Background This study attempted to determine the association between age and outcome for severe sepsis patients in the intensive care unit (ICU). Methods From May 2004 through April 2005, we conducted a prospective study of patients with severe sepsis in eight ICUs of Chi-Mei Medical Center. Demographic and clinical information, laboratory results, comorbidities, severity scores, mortality, and lengths of stays for both ICU and hospital were analyzed for older (age ≥ 65 years) and younger adult (age <65 years) patients. We analyzed the association between age and outcome and the predictors of hospital mortality. Results Of the 254 patients included, 63.8% were aged ≥65 years. ICU and hospital mortality rates were 50.4% and 55.1%, respectively, for older and younger adult patients. Both groups had similar baseline data, except that the older group had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, different comorbidities (less active cancer and alcoholism, but higher percentage of cerebral vascular accident) and more neurologic organ failure. Older patients also had higher ICU (54.3% vs. 43.5%, p = 0.097) and hospital mortality (58.0% vs. 50.0%, p = 0.216). Multivariate analyses showed the following predictors of hospital mortality: being female, active cancer, septic shock, acute respiratory distress syndrome, hematological failure, APACHE II scores >25, and inadequate drainage of infection site. Age was not a significant predictor for mortality after adjusting for other factors. Conclusion In this cohort, age was not an important predictor of mortality in ICU patients with severe sepsis. Physicians should consider other risk factors to improve outcomes in these critically ill aged patients.