Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study

Abstract Introduction We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU). Methods We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019–2021). Un...

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Main Authors: Tomer Hoffman, Ili Margalit, Alexis Tabah, Stéphane Ruckly, François Barbier, Pierre Singer, Jean-François Timsit, Virginie Prendki, Nasreen Hassoun-Kheir, Niccolò Buetti, Dafna Yahav, the EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP), Infections in the Elderly (ESGIE), the OUTCOMEREA Network
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-01-01
Series:Infectious Diseases and Therapy
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Online Access:https://doi.org/10.1007/s40121-024-01104-z
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author Tomer Hoffman
Ili Margalit
Alexis Tabah
Stéphane Ruckly
François Barbier
Pierre Singer
Jean-François Timsit
Virginie Prendki
Nasreen Hassoun-Kheir
Niccolò Buetti
Dafna Yahav
the EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP), Infections in the Elderly (ESGIE), the OUTCOMEREA Network
author_facet Tomer Hoffman
Ili Margalit
Alexis Tabah
Stéphane Ruckly
François Barbier
Pierre Singer
Jean-François Timsit
Virginie Prendki
Nasreen Hassoun-Kheir
Niccolò Buetti
Dafna Yahav
the EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP), Infections in the Elderly (ESGIE), the OUTCOMEREA Network
author_sort Tomer Hoffman
collection DOAJ
description Abstract Introduction We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU). Methods We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019–2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality. Results The cohort included 563 patients (median age 80, 39% women). Mortality at 28 day was 50%. Factors associated with mortality in multivariate analysis were admission due to COVID-19, failure to achieve source control, and higher SOFA. Among older adults with Gram-negative BSI, corticosteroid administration for septic shock was an additional factor. Among functionally independent patients, age itself was not associated with mortality. Conclusions HA-BSI in older adults in ICU are associated with high mortality. Inadequate source control is a significant modifiable risk factor. The use of corticosteroids in ICU management of older adults should be further investigated.
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spelling doaj-art-a9f50d73d16d42caa569bb83035e52c52025-08-20T03:00:58ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822025-01-0114248349210.1007/s40121-024-01104-zRisk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort StudyTomer Hoffman0Ili Margalit1Alexis Tabah2Stéphane Ruckly3François Barbier4Pierre Singer5Jean-François Timsit6Virginie Prendki7Nasreen Hassoun-Kheir8Niccolò Buetti9Dafna Yahav10the EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP), Infections in the Elderly (ESGIE), the OUTCOMEREA NetworkInfectious Diseases Unit, Sheba Medical CenterInfectious Diseases Unit, Sheba Medical CenterIntensive Care Unit, Redclife HospitalUniversité de Paris, INSERM, IAME UMR 1137Service de Médecine Intensive‑Réanimation, Centre Hospitalier Régional d’OrléansFaculty of Medicine and Health Sciences, Tel Aviv UniversityINSERM, IAME UMR 1137, Université Paris CitéDivision of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University HospitalsFaculty of Medicine, Infection Control Programme and World Health Organization Collaborating Center, Geneva University HospitalsFaculty of Medicine, Infection Control Programme and World Health Organization Collaborating Center, Geneva University HospitalsInfectious Diseases Unit, Sheba Medical CenterAbstract Introduction We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU). Methods We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019–2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality. Results The cohort included 563 patients (median age 80, 39% women). Mortality at 28 day was 50%. Factors associated with mortality in multivariate analysis were admission due to COVID-19, failure to achieve source control, and higher SOFA. Among older adults with Gram-negative BSI, corticosteroid administration for septic shock was an additional factor. Among functionally independent patients, age itself was not associated with mortality. Conclusions HA-BSI in older adults in ICU are associated with high mortality. Inadequate source control is a significant modifiable risk factor. The use of corticosteroids in ICU management of older adults should be further investigated.https://doi.org/10.1007/s40121-024-01104-zICUMortalityBSIOlder adultsRisk factors
spellingShingle Tomer Hoffman
Ili Margalit
Alexis Tabah
Stéphane Ruckly
François Barbier
Pierre Singer
Jean-François Timsit
Virginie Prendki
Nasreen Hassoun-Kheir
Niccolò Buetti
Dafna Yahav
the EUROBACT-2 Study Group, the European Society of Intensive Care Medicine (ESICM), the European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP), Infections in the Elderly (ESGIE), the OUTCOMEREA Network
Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
Infectious Diseases and Therapy
ICU
Mortality
BSI
Older adults
Risk factors
title Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
title_full Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
title_fullStr Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
title_full_unstemmed Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
title_short Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study
title_sort risk factors for mortality among older adults with hospital acquired bloodstream infections in the intensive care unit a multicenter cohort study
topic ICU
Mortality
BSI
Older adults
Risk factors
url https://doi.org/10.1007/s40121-024-01104-z
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