Dados do Trabalho

Título

Impact of frailty in community-acquired and hospital-acquired sepsis: a retrospective study

Objetivo

To describe the prevalence of frailty in septic patients and to assess frailty as a prognostic factor for mortality in community-acquired sepsis (CA) and hospital-acquired sepsis (HA).

Métodos

This retrospective study included adult patients diagnosed with sepsis between July 2022 and January 2023. Frailty was defined using the modified frailty index (mFi-11), with a score above 2 indicating frailty. Data were collected from the EPIMED®️ system and medical records.

Resultados

Frailty was observed in 126 out of 204 septic patients (61.4%), with 38.8% of patients classified as HA and 61.2% classified as CA. Frail patients were older (83 ± 10 vs 68 ± 21 years, p-value = 0.0001) and had higher SAPS3 scores (65.75 vs 59.21, p-value = 0.004). There were no significant differences in SOFA scores between frail and non-frail patients. Mortality of frail patients were 57,1% in HA and 16,.9% in CA. After multivariable analysis, adjusted to SOFA and comorbidities, frailty was an independent risk factor for mortality in HA (HR 2.77, 95% CI 1.37-5.98, p-value = 0.006), but not in CA. The mFi-11 score was a significant predictor of mortality in septic patients (OR 2.08, 95% CI 1,02-4.12, p-value = 0.03), even when compared with SIRS (OR 1.16, 95% CI 0.61-2.23, p-value = 0.64) and qSOFA scores (OR 1.76, 95% CI 0.96-3.37, p-value = 0.07).

Conclusão

Frailty is a prevalent condition among hospitalized patients and is associated with higher mortality in this population of patients with sepsis.