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Evaluation of humoral immune response to nosocomial pathogen and functional status in elderly patients with sepsis.
- Source :
-
Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2014 Jan-Feb; Vol. 58 (1), pp. 10-4. Date of Electronic Publication: 2013 Aug 30. - Publication Year :
- 2014
-
Abstract
- The clinical significance of humoral immune response to nosocomial pathogens and functional status in elderly patients with sepsis is not clear. We evaluated the humoral immune to nosocomial pathogens and the effect of functional dependencies on clinical outcomes among elderly patients with sepsis. This study prospectively enrolled patients aged ≥65 years with sepsis from September 2011 to May 2012 at a 2000-bed university hospital. The data including CD4 and CD8 T-cell count, functional status by measuring basic activities of daily living (ADL) and instrumental activities of daily living (IADL) were collected for all patients. In addition, the collected blood samples were analyzed for serum antibody levels against nosocomial pathogens using an ELISA. During the study period, 72 patients (38 males) treated with sepsis were enrolled. The all-cause in-hospital mortality rate was 16.7% (12/72). The mean CD4/CD8 T-cell ratio was significantly lower in nonsurvivors than in survivors (1.08 ± 0.72 vs. 1.93 ± 1.42, P=0.003). Serum antibody titers to Acinetobacter baumannii, Klebsiella pneumonia, Stenotrophomonas maltophilia, and Enterococcus faecalis were statistically higher in nonsurvivors than in survivors. On multivariate analysis, the IADL score was independently predictive of mortality in elderly patients with sepsis (odds ratio 1.410, 95% confidence interval 1.007-1.975, P=0.046). These results suggest that IADL scores could be used as predictors to identify elderly patients with a poor prognosis of nosocomial infections.<br /> (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Aged
Antibodies, Bacterial blood
CD4-CD8 Ratio
Cause of Death trends
Confidence Intervals
Cross Infection mortality
Cross Infection physiopathology
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Hospital Mortality trends
Humans
Male
Odds Ratio
Prognosis
Prospective Studies
Republic of Korea epidemiology
Sepsis mortality
Sepsis physiopathology
Time Factors
Activities of Daily Living
Antibodies, Bacterial immunology
Cross Infection immunology
Immunity, Humoral
Sepsis immunology
T-Lymphocytes immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1872-6976
- Volume :
- 58
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Archives of gerontology and geriatrics
- Publication Type :
- Academic Journal
- Accession number :
- 23998496
- Full Text :
- https://doi.org/10.1016/j.archger.2013.07.001