Insights into severe sepsis in older patients: From epidemiology to evidence-based management
Insights into severe sepsis in older patients: From epidemiology to evidence-based management
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DOI：
10.1086/427876
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发表时间：
2005-03-01
影响因子：
11.8
通讯作者：
Ely, EW
中科院分区：
文献类型：
--
作者：
Girard, TD;Opal, SM;Ely, EW
在美国，高达60%的严重脓毒症患者的年龄大于或等于65岁，并且脓毒症在这一人群中的发病率正在稳步增加。与年轻患者相比，老年患者发生脓毒症的风险增加，因为频繁的合并症，制度化，体能状态下降和免疫功能改变。老年脓毒症患者的临床表现往往是不典型的，导致诊断困难和延误。虽然年龄的增加似乎会增加因严重脓毒症而死亡的风险，但最近的证据表明，当及时启动干预措施时，许多老年患者对选定的干预措施反应良好。新出版的临床实践指南概述了关于严重脓毒症患者治疗的关键建议。临床医生必须意识到支持各种干预措施的证据水平，必须敏锐地筛选老年幸存者的持续缺陷，这将限制他们的功能恢复。
Up to 60% of patients who develop severe sepsis in the United States are greater than or equal to65 years of age, and the incidence of sepsis in this population is steadily increasing. Elderly individuals have an increased risk of developing sepsis, compared with younger patients, because of frequent comorbidities, institutionalization, declining performance status, and altered immune function. The clinical presentation of older patients with sepsis is often atypical, leading to a difficult and delayed diagnosis. Although increasing age appears to confer a high risk of death due to severe sepsis, recent evidence shows that many older patients respond well to selected interventions when the interventions are initiated in a timely fashion. Newly published clinical practice guidelines outline key recommendations regarding the treatment of patients with severe sepsis. Clinicians must be aware of the level of evidence in support of various interventions and must keenly screen older survivors for ongoing deficits that will limit their functional recovery.