The effect of ambulatory ability on the prognosis of elderly sepsis patients as an indicator of frailty

Jung, Changhwan; Cha, Kyungman; So, Byung Hak; Kim, Hyung Min; Jeong, Won Jung

J Korean Soc Emerg Med > Volume 32(3); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(3): 199-204.

노쇠의 지표로서 보행능력이 패혈증 환자의 예후에 미치는 영향

정창환

가톨릭대학교 성빈센트병원 응급의학과

The effect of ambulatory ability on the prognosis of elderly sepsis patients as an indicator of frailty

Department of Emergency Medicine, Suwon St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea

Correspondence

Kyungman Cha ,Tel: 031-249-7363, Fax: 031-253-4126, Email: drchaa@catholic.ac.kr,

Received: August 10, 2020; Revised: October 12, 2020 Accepted: October 12, 2020. Published online: June 30, 2021.

ABSTRACT

Objective:
The vulnerable and frail elderly individuals are at a compounded risk of worsening, rather than recovering, from external stress such as sepsis. Ambulation is majorly considered as a phenotype and determining factor of frailty. This study was undertaken to determine whether inability of ambulation is predictive for the prognosis of elderly patients afflicted with sepsis.
Method:
Data were collected retrospectively from the medical records of an emergency medical center, from 1 November 2016 to 28 February 2017. Patients older than 65 years, who underwent blood culture or with a diagnosis of sepsis or septic shock and with Sequential Organ Failure Assessment (SOFA) score above 2 points, were included in the study. The predictive ability of the clinical factors was analyzed by comparing with the primary outcome of in-hospital mortality.
Results:
A total of 105 patients were included in the study; 58 (55.2%) male and 47 (44.8%) female patients, with median age 78 years (range, 65-96 years). Of these, 89 (84.8%) patients were independently ambulatory before presentation. The median SOFA score was 3 (2-12), and 20 (19%) patients had expired in the hospital. Logistic regression revealed that inability of ambulation is not predictive of mortality (odds ratio, 0.872; 95% confidence Interval, 0.176-4.309; P=0.866). However, correlation analysis with the SOFA score revealed an association with inability of ambulation (r=0.277, P=0.004), and multiple regression analysis also showed that ambulation affects the SOFA score (t=2.435, P=0.017; t=-2.521, P=0.013).
Conclusion:
Inability of ambulation does not predict in-hospital mortality, but affects the SOFA score of elderly patients afflicted with sepsis or in septic shock.

Key words: Sepsis; Frailty; Aged; Walking; Prognosis