The effect of age on the clinical characteristics and innate immune cell function in the patients with abdominal sepsis

Abstract

Sepsis is a life-threatening dysregulated host response to infection that compromises organ health, and abdominal sepsis is a commonly presenting critical illness in intensive care units (ICU). In this study, we investigate the effect of age on clinical sepsis characteristics and innate immune cells (neutrophils and monocytes) functionality in abdominal sepsis patients. We recruited 32 patients with abdominal sepsis from the Beijing Ditan Hospital’s ICU from February 2021 to September 2021, and selected 18 healthy volunteers that were age- and sex-matched as controls for a prospective cohort study. Elderly abdominal sepsis patients (age >65 years) had the following altered characteristics compared to nonelderly patient controls: lower mean arterial pressure, monocytes percentage, and red blood cell volume distribution width (p < 0.05); higher neutrophils percentage and neutrophils-to-lymphocytes ratio (p < 0.05); significantly increased monocyte-produced reactive oxygen (p < 0.05); increases neutrophilic secretion of TNF-α, as well as lower monocytic secretion of TNF-α (p < 0.05); higher neutrophil percentage (which was significantly higher in peripheral blood than monocyte percentage). Elderly patients also had significantly increased phagocytic activity in their neutrophils and monocytes (p < 0.05), significantly reduced neutrophils-produced reactive oxygen (p < 0.001), and significantly increased TNF-α secretion by monocytes and neutrophils (p < 0.05). We found that elderly patients have decreased immune cell function and increased release of cytokines compared to younger patients, suggesting individualized treatment plans targeting the elderly septic microenvironment could help prevent organ failure in elderly septic patients and improves patient survival.

Long-Term Clinical Outcomes in Critically Ill Patients with Sepsis and Pre-existing Sarcopenia: A Retrospective Cohort Study

“…Since the chronic illnesses that account for secondary sarcopenia are also more prevalent in older patients [35], we analyzed the age-adjusted effects of sarcopenia on outcomes. We used an age cutoff of 70 years to define 'older' versus 'younger' patients with sepsis, based on data from previous epidemiologic studies [8,36,37]. While the incidence of sarcopenia was significantly lower in younger, septic patients (odds ratio 0.263), univariable Cox analysis of one-year mortality in 48 older patients demonstrated that age itself is not a significant predictor of one-year survival following sepsis (Table 4).…”

“…Sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [4], remains the leading cause of death in hospitalized patients [5][6][7]. Particularly adverse clinical outcomes are observed in septic patients who are older than 65 years [8].…”