Age-dependent differences in the association between blood interleukin-6 levels and mortality in patients with sepsis: a retrospective observational study

Journal of Intensive Care, Год журнала: 2025, Номер 13(1)

Опубликована: Янв. 13, 2025

Abstract Background Interleukin-6 (IL-6) is a cytokine that predicts clinical outcomes in critically ill patients, including those with sepsis. Elderly patients have blunted and easily dysregulated host responses to infection, which may influence IL-6 kinetics alter the association between levels outcomes. Methods This retrospective observational study included aged ≥ 16 years who were admitted intensive care unit at Chiba University Hospital. The categorized into two groups: non-elderly (< 70 years) elderly (≥ years). Associations log-transformed blood 28-day in-hospital mortality (primary outcome) multiple organ dysfunction (MOD) on days 3 7 (secondary outcomes) examined. Results groups 272 247 respectively. There no significant differences Sequential Organ Failure Assessment score, components of APACHE II score (Acute physiology Chronic health points), MOD baseline, or any outcome measures groups. In group, univariate Cox regression analysis showed (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.25–2.37, P < 0.001). remained after adjusting for sex, body mass index, steroid use prior sepsis onset, number chronic dysfunctions (HR 1.66, CI 1.20–2.32, = 0.002). However, was observed group either ( 0.69) multivariable analyses 0.77). Multivariable logistic revealed associations both Conclusions Blood significantly associated sepsis, but not patients. Therefore, should be interpreted caution when predicting Trial registration: Not applicable.

Язык: Английский

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Impact of frailty and older age on weaning from invasive ventilation: a secondary analysis of the WEAN SAFE study

Annals of Intensive Care, Год журнала: 2025, Номер 15(1)

Опубликована: Янв. 20, 2025

Abstract Objective To understand the impact of both frailty and chronologic age on outcomes weaning from invasive mechanical ventilation (MV). Methods The study population consisted patients enrolled in ‘WorldwidE. AssessmeNt Separation pAtients From ventilatory assistancE (WEAN SAFE) study. We defined 4 non-overlapping groups, namely: ‘frail’ (clinical scale [CFS] score > 4; < 80 years); ‘elderly’ (CFS ≤ ≥ 80y), ‘frail \elderly’ years), a ‘not frail or elderly’ population. primary outcome was older delayed failed MV. Secondary included ICU hospital survival. Results In population, 760 (17%) were frail, while 360 (8%) elderly, 197 (4%) 3,176 (70%) not elderly. elderly cohorts more likely to be female, had hypoxemic/hypercapnic respiratory failure sepsis, comorbidities. proportion MV significantly higher (28 23%), (25 19%), groups (22% 25%), compared (12% 13%, P 0.01). mortality (21 33%), (19 31%), (26 46%), 18%, 0.001). multivariate analyses, there an independent association between initiation failure. Old independently associated with risk Conclusions Frailty status consistent than outcomes. However, overall these are encouraging once separation attempts have been initiated.

Язык: Английский

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Refining mortality prediction in the transfer of sepsis patients: Biomarkers and frailty assessment

The American Journal of Emergency Medicine, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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Frailty as an independent risk factor for sepsis-associated delirium: a cohort study of 11,740 older adult ICU patients

Aging Clinical and Experimental Research, Год журнала: 2025, Номер 37(1)

Опубликована: Фев. 27, 2025

Abstract Background Sepsis-associated delirium (SAD) is a common complication in intensive care unit (ICU) patients and associated with increased mortality. Frailty, characterized by diminished physiological reserves, may influence the development of SAD, but this relationship remains poorly understood. Aims To comprehensively analyze assessment frailty as predictive factor for sepsis-associated older adults. Methods A retrospective cohort analysis was performed on sepsis aged ≥ 65 years admitted to ICU. Frailty assessed using Modified Index based 11 items including comorbidities functional status. Patients were categorized into non-frail (MFI: 0–2) frail (MFI 3) groups. Delirium ICU Confusion Assessment Method (CAM-ICU) nursing notes. Logistic regression used examine between risk delirium, odds ratios (OR) their 95% confidence intervals (CI) calculated. Results Among 11,740 (median age approximately 76 [interquartile range: 70.47–83.14], 44.3% female), tended have longer stays, higher severity scores, potentially worse clinical outcomes. The study found significant positive association MFI developing SAD (OR: 1.13, CI: 1.09–1.17, p < 0.001). Additionally, had compared 1.31, 1.20–1.43, Conclusions independently predicts adults ICU, emphasizing importance early recognition prevention.

Язык: Английский

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Revolution in sepsis: a symptoms-based to a systems-based approach?

Journal of Biomedical Science, Год журнала: 2024, Номер 31(1)

Опубликована: Май 30, 2024

Abstract Severe infection and sepsis are medical emergencies. High morbidity mortality linked to CNS dysfunction, excessive inflammation, immune compromise, coagulopathy multiple organ dysfunction. Males appear have a higher risk of than females. Currently, there few or no effective drug therapies protect the brain, maintain blood brain barrier, resolve inflammation reduce secondary injury in other vital organs. We propose major reason for lack progress is consequence treat-as-you-go, single-nodal target approach, rather more integrated, systems-based approach. A new revolution required better understand how body responds an infection, identify markers detect its progression discover system-acting drugs treat it. In this review, we present brief history followed by pathophysiology from systems’ perspective future opportunities. argue that targeting body’s early immune-driven CNS-response may improve patient outcomes. If barrage PAMPs DAMPs can be reduced early, CNS-organ circuits (or axes) will preserved reduced. been developing systems-based, small-volume, fluid therapy comprising adenosine, lidocaine magnesium (ALM) endotoxemia. Our studies indicate ALM shifts sympathetic parasympathetic dominance, maintains cardiovascular-endothelial glycocalyx coupling, reduces corrects coagulopathy, tissue O 2 supply. Future research investigate potential translation humans.

Язык: Английский

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Infection and Inflammation in Nuclear Medicine Imaging: The Role of Artificial Intelligence

Seminars in Nuclear Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

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Modified frailty index effectively predicts adverse outcomes in sepsis patients in the intensive care unit

Intensive and Critical Care Nursing, Год журнала: 2024, Номер 84, С. 103749 - 103749

Опубликована: Июнь 18, 2024

Язык: Английский

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Aging-induced dysbiosis worsens sepsis severity but is attenuated by probiotics in D-galactose-administered mice with cecal ligation and puncture model

PLoS ONE, Год журнала: 2024, Номер 19(10), С. e0311774 - e0311774

Опубликована: Окт. 18, 2024

Introduction Despite the well-established effects of aging on brain function and gut dysbiosis (an imbalance in microbiota), influence sepsis-associated encephalopathy (SAE) role probiotics this context remain less understood. Methods C57BL/6J mice (8-week-old) were subcutaneously administered with 8 weeks D-galactose (D-gal) or phosphate buffer solution (PBS) for non-aging models, respectively, without oral Lacticaseibacillus rhamnosus GG (LGG). Additionally, impact condition media from LGG (LCM) was tested macrophages (RAW 264.7 cells), microglia (BV-2 hippocampal cells (HT-22 cells). Result Fecal microbiome analysis demonstrated D-gal-induced (reduced Firmicutes Desulfobacterota increased Bacteroidota Verrucomicrobiota), which partially neutralized dysbiosis. D-gal also worsens cecal ligation puncture (CLP) sepsis severity when compared PBS-CLP mice, as indicated by serum creatinine (Scr) alanine transaminase (ALT), but not mortality, neurological characteristics (SHIRPA score), cytokines (TNF-α IL-6). supported fibrosis liver, kidney, lung; however, CLP did worsen fibrosis. Interestingly, attenuated all parameters (mortality, Scr, ALT, SHIRPA, cytokines) (PBS-CLP) while improving these parameters, except mortality IL-6, (D-gal CLP). For vitro test using lipopolysaccharide (LPS) stimulation, LCM inflammation some RAW264.7 BV-2 HT-22 cells, implying a direct anti-inflammatory effect macrophages, brain. Conclusion induced fecal worsened determined Scr could alleviate most selected sepsis, including SAE. However, SAE delivery beneficial molecules to partly due attenuation systemic through modulation macrophages.

Язык: Английский

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Inflammaging in Multidrug-Resistant Sepsis of Geriatric ICU Patients and Healthcare Challenges

Geriatrics, Год журнала: 2024, Номер 9(2), С. 45 - 45

Опубликована: Апрель 3, 2024

Multidrug-resistant sepsis (MDR) is a pressing concern in intensive care unit (ICU) settings, specifically among geriatric patients who experience age-related immune system changes and comorbidities. The aim of this review to explore the clinical impact MDR ICU shed light on healthcare challenges associated with its management. We conducted comprehensive literature search using National Center for Biotechnology Information (NCBI) Google Scholar engines. Our incorporated keywords such as "multidrug-resistant sepsis" OR "MDR sepsis", "geriatric patients" "elderly patients", "complications", "healthcare burdens", "diagnostic challenges", challenges" "ICU "geriatric/elderly patients". This explores specific risk factors contributing sepsis, complexities diagnostic challenges, burden faced by elderly patients. Notably, population bears higher (57.5%), influenced various factors, including comorbidities, immunosuppression, changes, resource-limited settings. Furthermore, imposes significant economic systems, annual costs exceeding $27 billion USA. These findings underscore urgency addressing need tailored interventions improve outcomes reduce costs.

Язык: Английский

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Albumin corrected anion gap and clinical outcomes in elderly patients with acute kidney injury caused or accompanied by sepsis: a MIMIC-IV retrospective study

European journal of medical research, Год журнала: 2025, Номер 30(1)

Опубликована: Янв. 7, 2025

Elderly acute kidney injury (AKI) occurring in the intensive care unit (ICU), particularly when caused or accompanied by sepsis, is linked to extended hospital stays, increased mortality rates, heightened prevalence of chronic diseases, and diminished quality life. This study primarily utilizes a comprehensive critical database examine correlation albumin corrected anion gap (ACAG) levels with short-term prognosis elderly patients AKI thus assisting physicians early identification high-risk patients. utilized data from Medical Information Mart for Intensive Care IV (MIMIC-IV, v2.0) database. The patient population was divided into death survival groups based on 14-day prognosis. Subsequently, entire further categorized normal ACAG group (12–20 mmol/L) high (> 20 levels. LASSO regression cross-validation method employed identify significant risk factors inclusion multivariate Cox analyses. A restricted cubic spline (RCS) then visually represent between Kaplan–Meier curves were plot cumulative rates at 14 30 days both groups. robustness findings subsequently evaluated through subgroup Our identified total 3741 eligible subjects, revealing higher all-cause 30-day intervals compared (χ2 = 87.023, P < 0.001; χ2 90.508, 0.001). analysis demonstrated that an elevated ICU admission independently posed factor 14- within this population. In addition, conducted using RCS revealed non-linear association cohort 18.220, 18.360, application statistically decrease among individuals (P Subgroup analyses indicated interacted cerebrovascular disease pancreatitis 0.05 interaction). Elevated are independent poor prognosis, correlating sepsis. highlights importance monitoring critically ill those adverse outcomes early.

Язык: Английский

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