Clinical presentation and factors predicting inhospital mortality in elderly patients with systemic inflammatory response syndrome

Abstract

Introduction: Increasing geriatric population imposes a significant burden on health-care resources. Compromised immunity and decreased organ reserves make them vulnerable for morbidity and mortality from various diseases. We aim to study the clinical profile of elderly patients hospitalized with systemic inflammatory response syndrome (SIRS) and identify factors predicting inhospital mortality. Materials and Methods: One hundred and two elderly patients (>60 years) fulfilling two or more SIRS criteria admitted between March 2019 and January 2020 in a tertiary care hospital of North India are prospectively studied. Results: The mean age of patients is 69.7 years. Hypertension (32.35%), chronic obstructive pulmonary disease (27.45%), and diabetes mellitus (20.58%) are common comorbidities. 65.6% of patients have SIRS with one or more organ dysfunction, and 29.4% have septic shock. Fever (73.52%) and cough (56.86%) are the most common presenting symptoms. The respiratory system is affected in 78 (76.47%) patients, followed by renal involvement in 66 (64.70%) patients. Thirty-nine (38.23%) patients need intensive care unit (ICU) care, 25 (24.50%) patients require mechanical ventilation, and 30 (29.11%) patients require inotropic support. Overall mortality is 35.3%. Factors associated with inhospital mortality need ICU care, organ dysfunction, septic shock, and need for mechanical ventilation and vasopressors. Conclusion: Geriatric patients hospitalized with SIRS have a high prevalence of multiple organ dysfunction, septic shock, ICU occupancy, and need for advanced life support along with increased overall and ICU mortality rate. This signifies the need for specialized geriatric ICUs and focused policymaking and allocation of health-care resources for geriatric care.

Keywords

• comorbidity
• elderly patients
• intensive care unit
• systemic inflammatory response syndrome