A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit

Abstract

Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world.

Methods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - <= 50, 51-60, 61-70, 71-80, >80 years. Sepsis was defined as infection plus at least one organ failure.

Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (<= 50 = 25.2%: 51-60 = 30.3%; 61-70 = 32.8%; 71-80 = 30.7%; >80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients <= 50 years (493% vs 25.2%, p < .05). The maximum rate of increase in mortality was about 0.75% per year, occurring between the ages of 71 and 77 years. In multilevel analysis, age > 70 years was independently associated with increased risk of dying.

Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved.

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[Passos, J.] Hosp Unimed Costa Do Sol Macae Rj, Macae, RJ, Brazil.

[Mendes, C.] Hosp Univ Ufpb Joao Pessoa, Joao Pessoa, Paraiba, Brazil.

[Grion, C.] Hosp Univ Londrina, Londrina, Brazil.

[Colozza Mecatti, G.] Hosp Univ Sao Francisco, Braganca Paulista, SP, Brazil.

[Ferrreira, M.] Santa Casa Caridade Diamantina, Diamantina, MG, Brazil.

[Irineu, V] Santa Casa Misericordia Tatui, Tatui, Brazil.

[Guerreiro, M.] Sao Francisco de Paula Hosp, Sao Francisco De Paula, RS, Brazil.

[Ugarte, S.] Clin Indisa, Providencia, Chile.

[Tomicic, V] Clin Las Lilas, Providencia, Chile.

[Godoy, C.] Hosp Carlos Van Buren, Valparaiso, Chile.

[Samaniego, W.] Hosp Trabajador Santiago, Santiago, Chile.

[Escamilla, I] Hosp El Pino, San Bernardo, Chile.

[Escamilla, I] Hosp Mutual De Seguridad, Santiago, Chile.

[Castro Castro, L.] Ctr Med Imbanaco, Valle Del Cauca, Colombia.

[Libreros Duque, G.] Clin Colombia Cali, Cali, Colombia.

[Diaz-Guio, D.] Clin Del Cafe, Armenia, Colombia.

[Benitez, F.] Clin La Estancia SA, Popayan, Colombia.

[Guerra Urrego, A.] Clin Medellin, Medellin, Colombia.

[Buitrago, R.] Fdn Clin Shaio, Bogota, Colombia.

[Ortiz, G.] Hosp Santa Clara, Bogota, Colombia.

[Villalba Gaviria, M.] Hosp Univ Fdn Santa Fe De Bogota, Bogota, Colombia.

[Salas, D.] Calderon Guardia Hosp, San Jose, Costa Rica.

[Ramirez-Arce, J.] Hosp Dr Rafael Angel Varlderon Guardia Ccss, San Jose, Costa Rica.

[Salgado, E.] Clin La Merced, Quito, Ecuador.

[Morocho, D.] Hosp Eugenio Espejo, Quito, Ecuador.

[Vergara, J.] Hosp Luis Vernaza, Quito, Ecuador.

[Chung Sang, M.] Shdug Sistema Hosp Docente De La Univ Guayaquil, Quito, Ecuador.

[Orellana-Jimenez, C.] Gen Hosp, San Salvador, El Salvador.

[Garrido, L.] Hosp Ctr Med, Guatemala City, Guatemala.

[Diaz, O.] Inst Hondureno Seguro Social, La Ceiba, Honduras.

[Resiere, D.] Ctr Hosp Univ Ft De France, Fort De France, Martinique, France.

[Osorio, C.] Ctr Estatal Cuidados Crit, Salamanca, Mexico.

[De La Vega, A.] Ctr Med Nacl 20 Noviembre Issste, Mexico City, DF, Mexico.

[Carrillo, R.] Fdn Clin Med Sur, Mexico City, DF, Mexico.

[Sanchez, V] Hosp San Jose TEC Monterrey, Monterrey, Mexico.

[Villagomez, A.] Hosp 1 Octubre, Issste, Mexico.

[Martinez Zubieta, R.] Hosp Espanol Mexico, Mexico City, DF, Mexico.

[Sandia, M.] Hosp Gen Ajusco Medio, Mexico City, DF, Mexico.

[Zalatiel, M.] Hosp Gen Guadalupe Victoria, Texcoco, Mexico.

[Poblano, M.] Hosp Juarez Mexico, Mexico City, DF, Mexico.

[Rodriguez Gonzalez, D.] Hosp Civil Guadalajara, Hspitaljuan I Menchaca, Guadalajara, Jalisco, Mexico.

[Arrazola, F.; Juan Francisco, L.] Inst Mexicano Seguro Social, Mexico City, DF, Mexico.

[Liamendys-Silva, S. A.] Inst Nacl Cancerol, Mexico City, DF, Mexico.

[Hernandez, M.] ISSSTE Guerra Moya, Mexico City, DF, Mexico.

[Hernandez, M.] Med Ctr ISSEMYM Toluca, Mexico City, DF, Mexico.

[Rodriguez Cadena, D.] Mixta, Mexico City, DF, Mexico.

[Lopez Islas, I.] Secretaria Salud Dist Fed, Mexico City, DF, Mexico.

[Ballesteros Zarzavilla, C.] Hosp Santo Comas, Panama City, Panama.

[Matos, A.] Social Secur Hosp, La Chorrera, Panama.

[Oyanguren, I] Clin Anglo Amer, Lima, Peru.

[Cerna, J.] Essalud, Lima, Peru.

[Quispe Sierra, R.] Hosp Nacl Dos De Mayo, Lima, Peru.

[Jimenez, R.] Hosp Rebagliati, Lince Dist, Peru.

[Castillo, L.] Inst Nacl Enfermedades Neoplas, Surquillo, Peru.

[Ocal, R.] Gulhane Med Fac, Istanbul, Turkey.

[Sencan, A.] Izmir Ataturk Educ & Res Hosp, Izmir, Turkey.

[Gianoni, S. Mareque] CAMS, Montevideo, Uruguay.

[Deicas, A.] CASMU, Montevideo, Uruguay.

[Hurtado, J.] Hosp Espanol Asse, Montevideo, Uruguay.

[Burghi, G.] Hosp Maciel, Montevideo, Uruguay.

[Martinelli, A.] Ctr Med Caracas, Caracas, Venezuela.

[Von der Osten, I] Hosp Miguel Perez Carreno, Caracas, Venezuela.

[Du Maine, C.] MSF Trauma Hosp Kunduz, Kunduz, Afghanistan.

[Bhattacharyya, M.] Amri Hosp, Kolkata, India.

[Bandyopadhyay, S.] Amri Hosp Salt Lake, Kolkata, W Bengal, India.

[Yanamala, S.] Apollo Hosp, Hyderabad, India.

[Gopal, P.] Apollo Hosp, Bangalore, Karnataka, India.

[Sahu, S.] Apollo Hosp, Bhubaneswar, India.

[Ibrahim, M.] Apollo Special Hosp, Chennai, Tamil Nadu, India.

[Rathod, D.] Asian Heart Inst, Mumbai, Maharashtra, India.

[Mukundan, N.] Baby Mem Hosp Ltd, Calicut, Kerala, India.

[Dewan, A.] Batra Hosp & Mrc, New Delhi 110062, India.

[Amin, P.] Bombay Hosp Inst Med Sci, Mumbai, Maharashtra, India.

[Samavedam, S.] Care Hosp, Hyderabad, India.

[Shah, B.] Cims Hosp, Ahmadabad, Gujarat, India.

[Gurupal, D.] Columbiaasia Hosp, Mysore, Karnataka, India.

[Lahkar, B.] Dispur Hosp, Gauhati, India.

[Mandal, A.] Fortis Hosp, Bangalore, Karnataka, India.

[Sircar, M.] Fortis Hosp, Noida, India.

[Ghosh, S.] Fortis Escorts Hosp, Faridabad, India.

[Balasubramani, V] Ganga Med Ctr & Hosp P Ltd, Coimbatore, Tamil Nadu, India.

[Kapadia, F.] Hinduja Hosp, Mumbai, Maharashtra, India.

[Vadi, S.] KDAH, Mumbai, Maharashtra, India.

[Nair, K.] Kerala Inst Med Sci, RMCC, Thiruvananthapuram, Kerala, India.

[Tripathy, S.] Kalinga Inst Med Sci, DTEM, Bhubaneswar, Odisha, India.

[Nandakumar, S.] Kovai Med Ctr & Hosp, Coimbatore, Tamil Nadu, India.

[Sharma, J.] Medanta Medic, Gurgaon, India.

[Kar, A.] Med Superspecialty Hosp, Kolkata, W Bengal, India.

[Jha, S.] Metro Heart Inst Multispecial, Faridabad, India.

[Gurav, K. Zirpe] Ruby Hall Pune, Pune, Maharashtra, India.

[Patel, M.] Saifee Hosp, Mumbai, Maharashtra, India.

[Bhaysar, A.] Spandan Multispecial Hosp, Vadodara, India.

[Samaddar, D.] Tata Main Hosp, Jamshedpur, Jharkhand, India.

[Kulkarni, A.] Tata Mem Hosp, Mumbai, Maharashtra, India.

[Hashmi, M.] Aga Khan Univ, Karachi, Pakistan.

[Ali, W.] Hearts Int Hosp, Rawalpindi, Pakistan.

[Nadeem, S.] Liaquat Natl Hosp, Karachi, Pakistan.

[Indraratna, K.] Sri Jayewardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri Lanka.

[Margarit, A.] Hosp Nostra Senyora Meritxell, Les Escaldes, Andorra.

[Urbanek, P.] Akh Wien, Vienna, Austria.

[Schlieber, J.] Allgemeines & Orthopad Landeskrankenhaus Stolzalp, Stolzalpe, Austria.

[Reisinger, J.] Barmherzige Schwestern Linz, Linz, Austria.

[Auer, U.] Gen Hosp Braunau, Braunau, Austria.

[Hartjes, A.] Krankenhaus D Barmherzigen Schwestern Ried II, Ried Im Innkreis, Austria.

[Lerche, A.] Krankenhaus Floridsdorf, Vienna, Austria.

[Janous, T.] LK Gmund Waidhofen Thaya Zwettl, Standort Zwettl, Austria.

[Kink, E.] LKH Horgas Enzenbach, Gratwein, Austria.

[Krahulec, W.] LKH West, Graz, Austria.

[Smolle, K.] Univ Hosp, Graz, Austria.

[Van der Schueren, M.] AZ Groeninge Kortrijk, Kortrijk, Belgium.

[Thibo, P.] AZ Jan Palfijn Gent, Ghent, Belgium.

[Vanhoof, M.] AZ Turnhout, Turnhout, Belgium.

[Ahmet, I] Bracops Anderlecht, Anderlecht, Belgium.

[Gadisseux, P.] Ctr Hosp Mouscron, Mouscron, Belgium.

[Dufaye, P.] CH Peltzer La Tourelle, Verviers, Belgium.

[Jacobs, O.] Chirec Edith Cavell, Auderghem, Belgium.

[Fraipont, V] CHR Citadelle, Liege, Belgium.

[Biston, P.] CHU Charleroi, Charleroi, Belgium.

[Dive, A.] CHU Mt Godinne, Yvoir, Belgium.

[Bouckaert, Y.] CHU Tivoli, La Louviere, Belgium.

[Gilbert, E.] CHwapi, Tournai, Belgium.

[Gressens, B.] Clin St Pierre Ottignies, Ottignies, Belgium.

[Pinck, E.] Clin Maternite St Elisabeth, Namur, Belgium.

[Collin, V] Clin Europe St Michel, Etterbeek, Belgium.

[Vincent, J. L.] Erasme Univ Hosp, Anderlecht, Belgium.

[De Waele, J.] Ghent Univ Hosp, Ghent, Belgium.

[Rimachi, R.] Moliere Hosp, Forest, Belgium.

[Gusu, D.] Notre Dame, Brussels, Belgium.

[De Decker, K.] Onze Lieve Vrouw Hosp, Aalst, Belgium.

[Mandianga, K.] Ixelles Hosp, Ixelles, Belgium.

[Heytens, L.] Sint Augustinus, Antwerp, Belgium.

[Wittebole, X.] St Luc Univ Hosp UCL, Brussels, Belgium.

[Spapen, H.] UZ Brussel, Brussels, Belgium.

[Olivier, V] Vivalia Site Libramt, Libramont, Belgium.

[Vandenheede, W.] VZW Gezondheidszorg Oostkust Knokke Heist, Knokke Heist, Belgium.

[Rogiers, P.] ZNA Middelheim, Antwerp, Belgium.

[Kolodzeike, P.] Herning Hosp, Herning, Denmark.

[Kruse, M.] Hjoerring Hosp, Hjorring, Denmark.

[Andersen, T.] Vejle Hosp, Vejle, Denmark.

[Harjola, V] Helsinki Univ Cent Hosp, Helsinki, Finland.

[Saarinen, K.] Seinajoki Cent Hosp, Seinajoki, Finland.

[Leone, M.] Aix Marseille Univ, Hop Nord, Marseille, France.

[Durocher, A.] Calmette Hosp, Lille, France.

[Moulront, S.] Ctr Hosp Dunkerque, Dunkerque, France.

[Lepape, A.] Ctr Hosp Lyon Sud, Lyon, France.

[Losser, M.] CHU Nancy Brabois, Nancy, France.

[Cabaret, P.] CH St Philibert, GHICL, Lille, France.

[Kalaitzis, E.] CHR Dax, Dax, France.

[Zogheib, E.] CHU Amiens, Amiens, France.

[Charve, P.] CHU Dijon, Dijon, France.

[Francois, B.] CHU Dupuytren, Limoges, France.

[Lefrant, J. Y.] CHU Nimes, Nimes, France.

[Beilouny, B.] Ctr Hosp Troyes, Troyes, France.

[Forceville, X.] Ctr Hosp Meaux, Grp Hosp Est Francilien, Meaux, France.

[Misset, B.] Grp Hosp Paris St Joseph, Paris, France.

[Jacobs, F.] Hop Antoine Beclere, Clamart, France.

[Floccard, B.] Hop Edouard Herriot, Lyon, France.

[Payen, D.] Hop Lariboisere, AP HP, Paris, France.

[Wynckel, A.] Hop Maison Blanche, Reims, France.

[Castelain, V] Hop Univ Strasbourg, Strasbourg, France.

[Faure, A.] Hosp Civils Lyon, Lyon, France.

[Lavagne, P.] CHU Grenoble, Grenoble, France.

[Thierry, I] CHU Nantes, Nantes, France.

[Moussa, M.] CHRU Lille, Reanimat Chirurg Cardiovasc, Lille, France.

[Vieillard-Baron, A.] Univ Hosp Ambroise Pare, Boulogne, France.

[Durand, M.] Univ Hosp Grenoble, La Tronche, France.

[Gainnier, M.] Univ Hosp Marseille, Marseille, France.

[Ichai, C.] Univ Nice, Nice, France.

[Arens, S.] Alexianer Krefeld Gmbh, Krefeld, Germany.

[Hoffmann, C.] Charite Hochschulmed Berlin, Berlin, Germany.

[Kaffarnik, M.] Charite, Berlin, Germany.

[Scharnofske, C.] Diakoniekrankenhaus Henriettenstiftung Gmbh, Hannover, Germany.

[Voigt, I] Elisabeth Krankenhaus Essen, Essen, Germany.

[Peckelsen, C.] Munich Municipal Hosp Grp, Harlaching Hosp, Munich, Germany.

[Weber, M.] Helios St Johannes Klin, Duisburg, Germany.

[Gille, J.] Hosp St Georg Leipzig, Leipzig, Germany.

[Lange, A.] Klin Hennigsdorf Oberhavel Kliniken Gmbh, Hennigsdorf, Germany.

[Schoser, G.] Klin Tettnang, Tettnang, Germany.

[Sablotzki, A.] Klinikum St Georg Leipzig, Leipzig, Germany.

[Jaschinski, U.; Bluethgen, A.] Klinikum Augsburg, Augsburg, Germany.

[Vogel, F.] Klinikum Bremen Mitte, Bremen, Germany.

[Tscheu, A.] Klinikum Bremen Ost, Bremen, Germany.

[Fuchs, T.] Klinikum Heidenheim, Heidenheim, Germany.

[Wattenberg, M.] Klinikum Links Weser Gmbh, Bremen, Germany.

[Helmes, T.] Klinikum Luedenscheid, Luedenscheid, Germany.

[Scieszka, S.] Krankenhaus Neuwerk, Monchengladbach, Germany.

[Heintz, M.] Marienkrankenhaus Schwerte, Schwerte, Germany.

[Sakka, S.] Med Ctr Cologne Merheim, Cologne, Germany.

[Kohler, J.] Schwarzwald Baar Klinikum Villingen Schwenningen, Villingen Schwenningen, Germany.

[Fiedler, F.] St Elisabeth Krankenhaus Koln Hohenlind, Cologne, Germany.

[Danz, M.] St Martinus Hosp Olpe, Olpe, Germany.

[Sakr, Y.] Uniklinikum Jena, Jena, Germany.

[Riessen, R.] Univ Klinikum Tubingen, Tubingen, Germany.

[Kerz, T.] Univ Med Mainz, Mainz, Germany.

[Kersten, A.] Univ Hosp Aachen, CPACC, Aachen, Germany.

[Tacke, F.] Univ Hosp Aachen, DMIII, Aachen, Germany.

[Marx, G.] Univ Hosp Aachen, OIC, Aachen, Germany.

[Volkert, T.] Univ Hosp Muenster, Munster, Germany.

[Schmutz, A.] Univ Med Ctr Freiburg, Fr