Mortality Risk Factors at Time on ED Admission in Elderly Patients with Infectious Diseases

Abstract

Background: As elderly individuals often exhibit heightened vulnerability to infections due to factors such as compromised immune systems, chronic illnesses, and age-related physiological changes, understanding the characteristics and risk factors associated with infectious diseases in this population is crucial. The aim of the present study was to evaluate the characteristics of elderly patients with infectious disease in ED admission and to identify risk factors that influence in-hospital mortality. Material and Method: In this study, we enrolled 448 adult patients diagnosed with infectious diseases such as pneumonia, urinary tract infection, gastroenteritis, meningitis, and cellulitis. The participants were directly admitted to our Emergency Department (ED) from their homes or their relatives' residences between November 1, 2014, and May 31, 2015. We investigated patient’s vital signs, disease signs, source of infection, length of staying at hospital, length of staying at emergency service, mortality related scores, laboratory data, treatment and prognosis. Results and Conclusion: The rate of emergency care admissions with an infectious etiology was found as 17%. Average age of patients was 76±8 with 180 (40%) of them being female and 268 (60%) of them being male. Mortality rate was found as 23%. Cox regression analysis concluded that for 65 years or older patients, risk factors that effected mortality were; septic shock, cardiac disease and presence of malignancy, absence of COPD/Asthma, higher pCO2 and lower HCO3 at the time of admission to the emergency service. Calculating MEDS score and APACHE 2 score at admission to the emergency department and intensive care unit can facilitate early intervention, improving recovery prospects. Further research and clinical strategies may benefit from these identified predictors to improve the management and outcomes of elderly patients with infectious diseases in the ED.