Sepsis and Immunosenescence in the Elderly Patient: A Review

Martín, Silvia; Pérez, A.I. Beltrán; Aldecoa, César

doi:10.3389/fmed.2017.00020

Cited by 109 publications

(102 citation statements)

References 79 publications

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“…Higher rates of mortality in seasonal A /H3 may be the result of delayed oseltamivir therapy as well as aging and comorbidities that lead to immune dysfunction in addition to concomitant immunosenescence. [24][25][26] This study found that the presentation to the hospital of patients with severe influenza was significantly delayed compared with patients with mild influenza (mean, 3 days versus 1.6 days). This finding suggests that there are delays in the timely commencement of antiviral therapy in severe cases.…”

Section: Discussionmentioning

confidence: 74%

Increased Mortality in Seasonal H3N2 Patients Compared with those with Pandemic 2009 H1N1 in Taiwan, 2009–2010

Huang

Chen

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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We conducted a retrospective study to compare clinical and laboratory findings between 1) severe influenza A and mild influenza A and 2) pandemic 2009 H1N1 (pdm09 A/H1) and seasonal H3N2 (A/H3) from 2009 to 2010. A total of 526 (mean age, 13.6 years; 447 pdm09 A/H1, 79 seasonal A/H3) patients were included, 41 (7.8%) with severe influenza (mean age, 28.1 years; 26 pdm09 A/H1, 15 seasonal A/H3). Influenza-associated complications were pneumonia (75.6%), meningoencephalitis (14.6%), acute kidney injury (14.6%), and acute respiratory distress syndrome (12.2%). Patients with seasonal A/H3 were significantly less likely to experience sore throat ( < 0.001), malaise ( < 0.001), and muscle pain ( < 0.001); they were significantly more likely to have hypertension ( < 0.001), diabetes mellitus ( = 0.001), and chronic obstructive pulmonary disease ( < 0.001), delayed hospital presentation ( = 0.001), delayed oseltamivir treatment ( < 0.001), and higher in-hospital mortality ( = 0.02) than patients with pdm09 A/H1. Further comparison between severe pdm09 A/H1 and severe seasonal A/H3 revealed that severe seasonal A/H3 patients (median age, 71 years) were significantly older than patients with severe pdm09 A/H1 (median age, 7 years) ( < 0.001). Comparison between severe influenza and mild influenza, regardless of influenza A subtypes, by multivariate analysis, found that tachypnea (odds ratio [OR] = 44.3, 95% confidence interval [CI] = 15.7-124.6) and delayed oseltamivir therapy ≧ 48 hours after illness onset (OR = 3.7, 95% CI = 1.3-10.5) were independent risk factors for severe influenza. The findings of this study will improve the understanding of the clinical differences between pdm09 A/H1 and seasonal A/H3, and of influenza-associated complications and predictors for severe outcomes that can help to direct clinicians toward the most effective management of influenza patients to reduce the preventable mortality and morbidity.

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Section: Discussionmentioning

confidence: 74%

Increased Mortality in Seasonal H3N2 Patients Compared with those with Pandemic 2009 H1N1 in Taiwan, 2009–2010

Huang

Chen

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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“…Based on 2016 National Report Sepsis 11 , sepsis can occur at various ages. According to a previous study conducted by Martin et al 12 patients with old age are more susceptible to infection due to decreased immunity factors, comorbidities, and malnutrition. Somatic mutations throughout a person's life will cause a decrease in cell regeneration capacity, cell repair, and immunity.…”

Section: Discussionmentioning

confidence: 98%

Correlation between Serum Mid-Regional Pro-Adrenomedullin and Sequential Organ Failure Assessment (SOFA) Score in Patient with Sepsis

Pujiyanti

Lismayanti²,

Rostini³

et al. 2019

mkb

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AbstrakMost sepsis will develop into multi organ failure (MOF). To assess manifestation of MOF, SOFA score that includes several laboratory parameters for each organ is used. However, this requires time and is also costly. Recently, Mid-Regional Pro-Adrenomedullin (MR proADM) biomarkers are stated to be an alternative marker of MOF in sepsis because MR proADM is secreted by endothelials that may increase in sepsis or bacterial infection. The aim of this study was to analyze the correlation between serum MR proADM levels and SOFA score. This was a crosssectional observational analytical study conducted in Dr. Hasan Sadikin General Hospital (RSHS) Bandung from August 2017 to July 2018. This study was a part of the bigger sepsis biomarker study. Samples used in this study consisted of 50 stored serum from the Sepsis Biomarker study in which the MR proADM was measured. Analysis using Spearman's correlation test showed a moderate positive correlation between serum MR proADM level and SOFA score (r=0,582, p=0.000), showing that MR proADM serum was directly proportional to SOFA score. It is concluded that MR proADM can be considered as one of the biomarkers for multi organ failure. AbstractSebagian besar sepsis akan berlanjut menjadi multi organ failure (MOF). Untuk mengetahui MOF digunakan skor SOFA yang memerlukan beberapa parameter laboratorium untuk tiap-tiap organ dan membutuhkan waktu dengan biaya yang mahal. Saat ini diketahui biomarker Mid Regional proAdrenomedullin (MR proADM) dapat digunakan sebagai biomarker MOF pada sepsis karena MR proADM disekresi oleh endotel yang akan meningkat pada keadaan sepsis atau infeksi bakteri. Tujuan penelitian ini mengetahui korelasi kadar MR proADM serum dengan skor SOFA. Penelitian ini bersifat observasional analitik dengan rancangan potong lintang yang dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Agustus 2017 sampai Juli 2018. Penelitian ini bagian dari payung penelitian "Biomarker pada sepsis". Bahan pemeriksaan berupa bahan biologis tersimpan sebanyak 50 sampel dan dilakukan pemeriksaan MR proADM. Hasil analisis menggunakan Spearman's correlation test menunjukkan korelasi positif sedang antara kadar MR proADM serum dan skor SOFA (r=0,582; p=0,000). Hal ini menunjukkan semakin tinggi kadar MR proADM serum maka semakin tinggi skor SOFA. Simpulan, terdapat korelasi positif sedang dan bermakna antara MR proADM dengan skor SOFA, sehingga MR proADM dapat dipertimbangkan sebagai salah satu biomarker pada multi organ failure.Kata kunci: Multi organ failure, MR proADM serum, sepsis, skor SOFA MKB. 51(2):118-21 https://doi.

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“…Increasing emphasis is being placed on personalized medicine (Fig ), and an important aspect to consider is aging. Indeed, the links between immunosenescence and sepsis have been poorly investigated (Martín et al , ), although immunosenescence is associated with increased sensitivity of aged people to infection (Fulop et al , ; Mannick et al , ). However, most experimental sepsis models are performed on murine teenagers.…”

Section: Sepsis: a New Who Global Health Prioritymentioning

confidence: 99%

Sepsis therapies: learning from 30 years of failure of translational research to propose new leads

2020

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Sepsis has been identified by the World Health Organization (WHO) as a global health priority. There has been a tremendous effort to decipher underlying mechanisms responsible for organ failure and death, and to develop new treatments. Despite saving thousands of animals over the last three decades in multiple preclinical studies, no new effective drug has emerged that has clearly improved patient outcomes. In the present review, we analyze the reasons for this failure, focusing on the inclusion of inappropriate patients and the use of irrelevant animal models. We advocate against repeating the same mistakes and propose changes to the research paradigm. We discuss the long‐term consequences of surviving sepsis and, finally, list some putative approaches—both old and new—that could help save lives and improve survivorship.

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Sepsis and Immunosenescence in the Elderly Patient: A Review

Cited by 109 publications

References 79 publications

Increased Mortality in Seasonal H3N2 Patients Compared with those with Pandemic 2009 H1N1 in Taiwan, 2009–2010

Increased Mortality in Seasonal H3N2 Patients Compared with those with Pandemic 2009 H1N1 in Taiwan, 2009–2010

Correlation between Serum Mid-Regional Pro-Adrenomedullin and Sequential Organ Failure Assessment (SOFA) Score in Patient with Sepsis

Sepsis therapies: learning from 30 years of failure of translational research to propose new leads

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