Skip to main content

Advertisement

Log in

Serum albumin is a strong predictor of sepsis outcome in elderly patients

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The incidence of sepsis is disproportionately higher in elderly adults, and age is an independent predictor of mortality. Retrospective analysis was conducted among patients admitted to the emergency department in a tertiary teaching hospital from January 2016 to June 2017. To study the prognosis determinants of sepsis among elderly patients attended in the emergency room of a tertiary care hospital. As secondary objectives, we aimed to describe the causes of sepsis, the general outcome, and the general characteristics of these patients. Two hundred thirty-five episodes data of patients admitted throughout the 15-month study period who were diagnosed with sepsis, severe sepsis or septic shock, were included. Throughout the study cohort, 51 patients (21.7%) fulfilled the criteria of severe sepsis or septic shock. All-cause mortality was 11 patients (4.7%) on day 14 and 27 (11.5%) on day 30. Prognosis factors associated with 30-day mortality were the following: albumin level < 2.6 g/dl (first quartile of the overall population), odds ratio (OR 3.26, 95% CI 12–9.41; p = 0.029), Charlson comorbidity index (OR 1.23, 95% CI 1.04–1.45; p = 0.012), C-reactive protein on admission (OR 1.04, 95% CI 0.99–1.08; p = 0.062), and non-adequacy of the initial antimicrobial therapy (OR 3.3, 95% CI 1.06–10.4; p = 0.039). Among elderly patients with sepsis, strong predictors of mortality such as albumin could be considered as part of prognosis and future potential interventions. Adequacy of antimicrobial therapy at admission must be one of the objectives in the treatment of sepsis, also in the elderly, since it is an independent predictor of mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Juneja D (2012) Severe sepsis and septic shock in the elderly: an overview. World J Crit Care Med 1(1):23

    Article  PubMed  PubMed Central  Google Scholar 

  2. Martín S, Pérez A, Aldecoa C (2017) Sepsis and immunosenescence in the elderly patient: a review. Front Med 4(February):e1959

    Google Scholar 

  3. Capdevila JA, Diez LF, Artero A, Inglada L, Go A, Romero M et al (2018) The clinical impact of bacteremia on outcomes in elderly patients with pyelonephritis or urinary sepsis: a prospective multicenter study. PLoS One 13(1):e0191066

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Martin GS, Mannino DM, Moss M (2006) The effect of age on the development and outcome of adult sepsis. Crit Care Med 34(1):15–21

    Article  PubMed  Google Scholar 

  5. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D et al (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 31(4):1250–1256

    Article  PubMed  Google Scholar 

  6. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al (2016) The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 315(8):801–810

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Famakin B, Weiss P, Hertzberg V, McClellan W, Presley R, Krompf K et al (2010) Hypoalbuminemia predicts acute stroke mortality: Paul Coverdell Georgia Stroke Registry. J Stroke Cerebrovasc Dis 19(1):17–22

    Article  PubMed  Google Scholar 

  8. Carter AM, Catto AJ, Mansfield MW, Bamford JM, Grant PJ (2007) Predictive variables for mortality after acute ischemic stroke. Stroke 38(6):1873–1880

    Article  PubMed  Google Scholar 

  9. Cho Y-M, Choi I-S, Bian R-X, Kim J-H, Han J-Y, Lee S-G (2008) Serum albumin at admission for prediction of functional outcome in ischaemic stroke patients. Neurol Sci 29(6):445–449

    Article  PubMed  Google Scholar 

  10. Plakht Y, Gilutz H, Shiyovich A (2016) Decreased admission serum albumin level is an independent predictor of long-term mortality in hospital survivors of acute myocardial infarction. Soroka Acute Myocardial Infarction II (SAMI-II) project. Int J Cardiol 219:20–24

    Article  PubMed  Google Scholar 

  11. Pioli G, Barone A, Giusti A, Oliveri M, Pizzonia M, Razzano M et al (2006) Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res 18(5):381–387

    Article  CAS  PubMed  Google Scholar 

  12. Churpek MM, Snyder A, Han X, Sokol S, Pettit N, Howell MD et al (2017) Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. Am J Respir Crit Care Med 195(7):906–911

    Article  PubMed  PubMed Central  Google Scholar 

  13. Akirov A, Masri-Iraqi H, Atamna A, Shimon I (2017) Low albumin levels are associated with mortality risk in hospitalized patients. Am J Med 130(12):1465.e11–1465.e19

    Article  CAS  Google Scholar 

  14. MacArthur RD, Miller M, Albertson T, Panacek E, Johnson D, Teoh L et al (2004) Adequacy of early empiric antibiotic treatment and survival in severe sepsis: experience from the MONARCS trial. Clin Infect Dis 38(2):284–288

    Article  PubMed  Google Scholar 

  15. Leibovici L, Drucker M, Konigsberger H, Samra Z, Harrari S, Ashkenazi S et al (1997) Septic shock in bacteremic patients: risk factors, features and prognosis. Scand J Infect Dis 29(1):71–75

    Article  CAS  PubMed  Google Scholar 

  16. Behrendt G, Schneider S, Brodt HR, Just-Nübling G, Shah PM (1999) Influence of antimicrobial treatment on mortality in septicemia. J Chemother 11(3):179–186

    Article  CAS  PubMed  Google Scholar 

  17. Askim Å, Moser F, Gustad LT, Stene H, Gundersen M, Åsvold BO et al (2017) Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department. Scand J Trauma Resusc Emerg Med 25(1):56–64

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

IAB, RGF, SL, LS, OV, and RM designed the study. IAB and RGF collected data. RGF and IAB did the statistical analysis. RGF, IAB, SL, and LS prepared the manuscript. IAB, RGF, SL, LS, OV, and RM reviewed the manuscript. Robert Güerri-Fernández is a member of the European Society of Clinical Microbiology and Infectious Diseases—Study Group for Infections in the Elderly (ESGIE) and would like to thank ESGIE members for their stimulating support to write this article

Corresponding author

Correspondence to Robert Güerri-Fernández.

Ethics declarations

This study was submitted and approved by the IRB. No informant consent was needed.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arnau-Barrés, I., Güerri-Fernández, R., Luque, S. et al. Serum albumin is a strong predictor of sepsis outcome in elderly patients. Eur J Clin Microbiol Infect Dis 38, 743–746 (2019). https://doi.org/10.1007/s10096-019-03478-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-019-03478-2

Keywords

Navigation