Observational studyThe journal of trauma and acute care surgery2018
The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical intensive care unit patients.
Observational study in The journal of trauma and acute care surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed.
- Blood biomarker trajectories in ICU-directed prediction models - A scoping review.The EPMA journal · 2026Review
- Age-Associated Impairment of Paneth Cells Driven by microRNA-152 Promotes Intestinal Epithelial Vulnerability to Pathological Stress.Aging cell · 2026Article
- Advanced Age in Mice Exacerbates Sepsis-Induced Inflammation, Vascular Permeability, and Multi-Organ Dysfunction.Shock (Augusta, Ga.) · 2026Article
- Identification of distinct immune subtypes in sepsis through dual immunomarker trajectory.Annals of intensive care · 2026Article
- A murine model of sepsis induces age- and sex-specific chromatin remodeling in myeloid-derived suppressor cells.Frontiers in immunology · 2026Article
- Impact of complement C3 levels on the development of healthcare-associated infections in intensive care patients: a retrospective case-control study.Annals of medicine · 2025Article
- Sepsis Induces Age- and Sex-Specific Chromatin Remodeling in Myeloid-Derived Suppressor Cells.bioRxiv : the preprint server for biology · 2025Article
- Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice.Critical care (London, England) · 2024Article
- Sepsis-Related Lung Injury and the Complication of Extrapulmonary Pneumococcal Pneumonia.Diseases (Basel, Switzerland) · 2024Review
- Decreased Glycocalyx Shedding on Presentation in Hemorrhaging Geriatric Trauma Patients.The Journal of surgical research · 2024Article
- Association of Traumatic Injury and Incident Myocardial Infarction and Stroke: A Prospective Population-Based Cohort Study.Reviews in cardiovascular medicine · 2023Article
- [Early changes within the lymphocyte population are associated with the long term prognosis in severely injured patients].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2022Article
- Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients: A Multicenter Prospective Observational Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
- Septic patients without obvious signs of infection at baseline are more likely to die in the ICU.BMC infectious diseases · 2022Observational
- The Risk Factors for Mortality among Septic Trauma Patients: A Retrospective Cohort Study Using the National Trauma Data Bank.Emergency medicine international · 2022Article
- Interpretable Machine Learning to Optimize Early In-Hospital Mortality Prediction for Elderly Patients with Sepsis: A Discovery Study.Computational and mathematical methods in medicine · 2022Article
- Chronic Critical Illness Elicits a Unique Circulating Leukocyte Transcriptome in Sepsis Survivors.Journal of clinical medicine · 2021Article
- Relative platelet reductions provide better pathophysiologic signatures of coagulopathies in sepsis.Scientific reports · 2021Article
- Development and internal validation of a simple prognostic score for early sepsis risk stratification in the emergency department.BMJ open · 2021Article
- The impact of hindlimb disuse on sepsis-induced myopathy in mice.Physiological reports · 2021Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundAdvancing age is a strong risk factor for adverse outcomes across multiple disease processes. However, septic surgical and trauma patients are unique in that they incur two or more inflammatory insults. The effects of advanced age on sepsis pathophysiology and outcomes remain unclear.
methodsWe performed a single-center, prospective observational cohort study of surgical intensive care unit patients with severe sepsis/septic shock. Peripheral blood was collected for genomic, cytokine, and biomarker analysis at 0.5 day, 1 day, 4 days, 7 days, 14 days, 21 days, and 28 days after sepsis onset. Based on sensitivity analysis, cohorts were defined as "young" (<55 years) and "aged" (≥55 years). We compared age-defined cohorts to determine differences in patient characteristics, biomarker profiles, and clinical outcomes.
resultsThe cohort included 173 patients with severe sepsis (n = 93; 53.8%) or septic shock (n = 80; 46.2%), with a mean age of 60.9 (±14.5) years. Intra-abdominal sepsis was the leading source (n = 81; 46.8%), followed by necrotizing soft tissue infection (n = 33, 19.1%) and pneumonia (n = 30; 17.3%). Aged patients had a higher comorbidity burden, but were otherwise similar to the young cohort. The aged cohort had a higher severity of early physiologic derangement (median APACHE II, 23 vs. 18; p = 0.002), greater incidence of multiple organ failure (64.3% vs. 40.4%, p = 0.006), and hospital mortality (15.9% vs. 2.1%; p = 0.016). Six-month mortality was significantly higher in the aged cohort as compared with young cohort (31% vs. 9%; p = 0.003). Aged septic patients biomarker trajectories suggestive of persistent immunosuppression (absolute lymphocyte count, soluble programed death ligand-1) and catabolism (Urine 3MH-Cr ratio, insulin growth factor, IGF1BP3, albumin) out to 28 days after sepsis.
conclusionAged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism. Advanced age may necessitate novel therapeutic strategies to promote multisystem organ recovery and improve survival after sepsis. LEVEL OF EVIDENCE: Prognostic, level II.
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