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Comparison of factors associated with mortality from bacteraemias in individuals aged 60-70 years old and in those aged more than 70 years

Abstract:

OBJECTIVE: The aim of this study was to analyze the factors associated with death from bacteraemias and fungemias over a 1-year period and to compare the results in individuals aged 60-70 years old with those in individuals aged more than 70 years. PATIENTS AND METHODS: We performed a prospective, descriptive study of all episodes of bacteraemias-fungemias in the Princesa de Madrid University Hospital between 16/5/1996 and 14/5/1997. The same definitions were used in both study groups. Univariate analysis was performed with the Chi-square test and variables with more than two categories were analyzed using logistic regression. Values of p < 0.05 were considered statistically significant. RESULTS: A total of 250 episodes were analyzed. There were 158 episodes in individuals aged more than 70 years and 92 episodes in the group of patients aged 60-70 years. Overall, there was no difference in mortality between the two groups: OR 1.22 (0.66-2.24). The department with the greatest number of episodes of bacteraemia in both groups was the medical department. The microorganisms most frequently associated with bacteraemia were Gram-negative. Extrahospital acquisition was more frequent than intrahospital acquisition. The most frequent origins were vascular procedures in the group aged 60-70 years and genitourinary procedures in the group aged more than 70 years. Appropriate surgical treatment was frequent in both groups. The clinically and statistically significant variables associated with mortality in the group aged 60-70 years were: intrahospital acquisition [OR 6.28 (1.9-20.7)], hypotension [OR 4.46 (1.14-17.4)], and disseminated intravascular coagulation [OR 4.93 (3.14-7.75)]. However, lower mortality was associated with appropriate surgical treatment [OR 10.76 (2.017-57.05)]. In the group aged more than 70 years, the factors associated with mortality were: prior use of antibiotics [OR 2.71 (1.25-6.13)], hypotension [OR 3.35 (1.34-8.36)], thrombopenia [OR 2.7 (0.97-7.69)], and disseminated intravascular coagulation [OR 7.51 (0.65-83)]. However, appropriate surgical treatment was also associated with improved prognosis in this group [OR 6.03 (1.62-22.35)]. CONCLUSIONS: No differences were found in mortality between patients aged 60-70 years and those aged more than 70 years. Many of the variables were similar in both groups. Notable was the association between improved prognosis and appropriate surgical treatment, which should encourage the use of this type of intervention, when required, independent of age.