The Effect of Sepsis Associated Encephalopathy on One-Year Mortality in Patients Aged 65 Years and Over After Discharge: A Retrospective Cohort Study

Abstract

Aim: Sepsis remains a leading cause of mortality among the older hospitalized patients, particularly those with complex comorbidities. This study investigates the prognostic factors influencing one-year mortality in patients aged 65 years and over, who were hospitalized with sepsis, emphasizing the role of sepsis-associated encephalopathy (SAE) in long-term outcomes. Materials and Methods: In a retrospective cohort of 207 older patients treated for sepsis, clinical and laboratory data were meticulously recorded. Demographic details, comorbidity indices, and specific treatment interventions were analyzed. The association between these variables and one-year mortality was evaluated using univariate and multivariate Cox regression models. The Kaplan-Meier curves, complemented by the Log-rank test, assessed the survival probabilities. Results: The cohort consisted of patients with a nearly equal gender distribution, with a mean age of 73.7 years. The study found that SAE, increased international normalized ratio (INR), and advanced age were significantly associated with higher one-year mortality (p<0.05). Notably, SAE presented a hazard ratio of 3.41 in the multivariate analysis. Other factors such as gender, Charlson Comorbidity Index, Sequential Organ Failure Assessment score and various laboratory markers did not show significant prognostic value. Conclusion: SAE and elevated INR are potent predictors of one-year mortality in older sepsis survivors. These findings highlight the importance of close neurological assessment and monitoring of coagulation parameters in this population. Focused strategies on these elements could potentially improve the management and outcomes of sepsis in the older patients.

Keywords

• sepsis
• encephalopathy
• mortality