P2429 Prevalence, risk and prognostic factors related to sepsis in very old patients
with community-acquired pneumonia
Catia Cilloniz Campos*1, Cristina Dominedo2, Antonella Ielpo3, Miguel Ferrer1, Albert Gabarrus1, Jesus F. BermejoMartin4, Carolina Garcia Vidal1, Adamantia Liapikou5, Andrea Meli6, Denise Battaglini7, Antoni Torres1
1 Hospital Clínic, Barcelona, Spain, 2 Fondazione Policlinico Universitario A. Gemelli - Presidio Columbus, Roma,
Italy, 3 University of Parma - , Parma, Italy, 4 Hospital Clínico Universitario de Valladolid - Edificio Rondilla,
Valladolid, Spain, 5 Sotiria Chest Diseases Hospital, Greece, 6 University of Milan, Milano, Italy, 7 Hospital Policlinico
San Martino - , Genova, Italy
Background: There is limited information about sepsis in very old patients (≥80 years) hospitalized with
community-acquired pneumonia (CAP). We aimed to investigate the prevalence, characteristics, etiology, risk
factors and clinical outcomes of sepsis in very old patients with CAP using the SEPSIS-3 definition compared with
very old patients without sepsis.
Materials/methods: We conducted a retrospective observational study using data that were prospectively
collected at the Hospital Clinic of Barcelona. We included all very old patients hospitalized with CAP over a 12-year
period. The main clinical outcome was 30-day mortality.
Results: Among 4,190 patients hospitalized with CAP, 1,136 (27%) were very old (≥80 years). The incidence of
sepsis in very old patients was 70% (n = 795). Men (OR 1.86 [95% CI 1.21 to 3.25]) and chronic renal disease (OR
2.01 [95% CI 1.22 to 3.29]) were independent risk factors for sepsis in the multivariable analysis, while prior
antibiotic therapy before admission (OR 0.71 [95% CI 0.53 to 0.95]) was independently associated to a lower risk
for this condition. One-year mortality was higher in very old septic patients compared with patients without sepsis.
A propensity-adjusted multivariable analysis showed that risk factors for 30-day mortality in septic patients were
chronic renal disease (OR 2.62 [95% CI 1.36 to 5.03]) and neurological disease (OR 2.56 [95% CI 1.47 to 4.46]),
while diabetes mellitus (OR 0.43 [95% CI 0.21 to 0.87]) was a protective factor.
Conclusions: Sepsis affected very old patients with CAP in high proportion. Prior antibiotic therapy before
admission was associated with a decreased risk of sepsis whereas diabetes mellitus was associated with a
decreased risk of 30-day mortality.
29TH ECCMID
13-16 APRIL 2019 AMSTERDAM, NETHERLANDS
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