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

Hoffman, Tomer; Margalit, Ili; Tabah, Alexis; Ruckly, Stéphane; Barbier, François; Singer, Pierre; Timsit, Jean-François; Prendki, Virginie; Hassoun-Kheir, Nasreen; Buetti, Niccolo; Yahav, Dafna; EUROBACT-2 Study Group; European Society of Intensive Care Medicine (ESICM); European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP); Infections in the Elderly (ESGIE); OUTCOMEREA Network

doi:10.1007/s40121-024-01104-z

Scientific article

English

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

ContributorsHoffman, Tomer; Margalit, Ili

; Tabah, Alexis; Ruckly, Stéphane; Barbier, François; Singer, Pierre; Timsit, Jean-François; Prendki, Virginie

; Hassoun-Kheir, Nasreen; Buetti, Niccolo; Yahav, Dafna; EUROBACT-2 Study Group; European Society of Intensive Care Medicine (ESICM); European Society of Clinical Microbiology, Infectious Diseases (ESCMID) Study Groups for Infections in Critically Ill Patients (ESGCIP); Infections in the Elderly (ESGIE); OUTCOMEREA Network

Published inInfectious diseases and therapy, vol. 14, no. 2, p. 483-492

Publication date2025-02

First online date2025-01-11

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.

Keywords

BSI
ICU
Mortality
Older adults
Risk factors

Affiliation entities

Research groups

Funding

Swiss National Science Foundation - Epidemiology and determinants of catheter-related and hospital-acquired bloodstream infections: from a large university hospital to a global picture [194449]

Citation (ISO format)

HOFFMAN, Tomer et al. Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit : A Multicenter Cohort Study. In: Infectious diseases and therapy, 2025, vol. 14, n° 2, p. 483–492. doi: 10.1007/s40121-024-01104-z