Factors for predicting 28-day mortality in older patients with suspected of having sepsis in the emergency department

Abstract

Background: Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28-day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods: We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28-day mortality. Results: A total of 329 older patients with suspected sepsis were included. The overall 28-day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28-day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p < 0.01), oxygen saturation ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p < 0.01), and dependent status (hazard ratio [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02). Conclusions: This study suggests that “MOD”; M-Malignancy, O-Oxygen saturation ≤93%, and D-Dependent status are significant prognostic indicators for 28-day mortality among older patients with suspected sepsis in the ED. Trial registration: The trial was retrospectively registered in the Thai Clinical Trial Registry on 06/05/2022, identification number TCTR20220506006.