Sepsis is an increasingly common and lethal medical condition. As many as 60% of patients who develop sepsis in the United States are older than 65 years of age. Mortality rates for sepsis are known to increase with age. Gender differences have also been described. Sepsis induced deficits in tissue perfusion and oxygen delivery may result in increases in serum Lactate and Troponin I (TnI) levels. The purpose of this study was to examine the prognostic utility of serum Lactate and TnI levels in male and female elderly (age: 65–84) and very elderly (age>84) patients with septic shock compared to younger patients (age<65).
Retrospective/Prospective review of all patients admitted with septic shock in the ICU at Kuakini Medical Center in Honolulu, Hawaii from January 1, 2007–December 31, 2008.
377 patients (189 Males and 188 Females) admitted with septic shock were identified. Overall mortality rates were higher in males than females (41% vs. 28%). Mortality was highest in very elderly (age>85) males (60%) and lowest in younger (age<65) females (17%). Serum lactate levels were significantly higher in non-surviving males (p<.01). Serum lactate levels were less predictive of mortality in very elderly females but still significantly higher in expiring younger (age<84) females (p<.01). TnI levels were significantly higher in elderly and very elderly females that expired (p<.05). TnI levels were significantly higher in younger non-surviving males (age<65, p=.008).
Mortality rates in elderly patients with septic shock increase with age. Mortality rates appear higher in male patients regardless of age. Serum lactate measurements appeared to be useful predictors of mortality in all males and females aged 84 and younger. Serum TnI measurements appeared to be useful predictors of mortality in older females and in contrast, younger males.
There are gender differences in mortality rates in elderly patients with septic shock. The usefulness of serum lactate and TnI measurements as prognostic markers of mortality may differ by gender and age in elderly patients with septic shock.
Jennie Kaya, No Financial Disclosure Information; No Product/Research Disclosure Information