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KMID : 0385920210320030199
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Journal of the Korean Society of Emergency Medicine
2021 Volume.32 No. 3 p.199 ~ p.204
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The effect of ambulatory ability on the prognosis of elderly sepsis patients as an indicator of frailty
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Jung Chang-Hwan
Cha Kyung-Man
So Byung-Hak
Kim Hyung-Min
Jeong Won-Jung
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Abstract
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Objective: The vulnerable and frail elderly individuals are at a compounded risk of worsening, rather than recovering, from external stress such as sepsis. Ambulation is majorly considered as a phenotype and determining factor of frailty.
This study was undertaken to determine whether inability of ambulation is predictive for the prognosis of elderly patients afflicted with sepsis.
Methods: Data were collected retrospectively from the medical records of an emergency medical center, from 1 November 2016 to 28 February 2017. Patients older than 65 years, who underwent blood culture or with a diagnosis of sepsis or septic shock and with Sequential Organ Failure Assessment (SOFA) score above 2 points, were included in the study. The predictive ability of the clinical factors was analyzed by comparing with the primary outcome of in-hospital mortality.
Results: A total of 105 patients were included in the study; 58 (55.2%) male and 47 (44.8%) female patients, with median age 78 years (range, 65-96 years). Of these, 89 (84.8%) patients were independently ambulatory before presentation.
The median SOFA score was 3 (2-12), and 20 (19%) patients had expired in the hospital. Logistic regression revealed that inability of ambulation is not predictive of mortality (odds ratio, 0.872; 95% confidence Interval, 0.176-4.309; P=0.866). However, correlation analysis with the SOFA score revealed an association with inability of ambulation (r=0.277, P=0.004), and multiple regression analysis also showed that ambulation affects the SOFA score (t=2.435, P=0.017; t=-2.521, P=0.013).
Conclusion: Inability of ambulation does not predict in-hospital mortality, but affects the SOFA score of elderly patients afflicted with sepsis or in septic shock.
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KEYWORD
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Sepsis, Frailty, Aged, Walking, Prognosis
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