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J Korean Soc Emerg Med > Volume 32(3); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(3): 199-204.
노쇠의 지표로서 보행능력이 패혈증 환자의 예후에 미치는 영향
정창환 , 차경만 , 소병학 , 김형민 , 정원중
가톨릭대학교 성빈센트병원 응급의학과
The effect of ambulatory ability on the prognosis of elderly sepsis patients as an indicator of frailty
Changhwan Jung , Kyungman Cha , Byung Hak So , Hyung Min Kim , Won Jung Jeong
Department of Emergency Medicine, Suwon St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
Correspondence  Kyungman Cha ,Tel: 031-249-7363, Fax: 031-253-4126, Email: drchaa@catholic.ac.kr,
Received: August 10, 2020; Revised: October 12, 2020   Accepted: October 12, 2020.  Published online: June 30, 2021.
ABSTRACT
Objective:
The vulnerable and frail elderly individuals are at a compounded risk of worsening, rather than recovering, from external stress such as sepsis. Ambulation is majorly considered as a phenotype and determining factor of frailty. This study was undertaken to determine whether inability of ambulation is predictive for the prognosis of elderly patients afflicted with sepsis.
Method:
Data were collected retrospectively from the medical records of an emergency medical center, from 1 November 2016 to 28 February 2017. Patients older than 65 years, who underwent blood culture or with a diagnosis of sepsis or septic shock and with Sequential Organ Failure Assessment (SOFA) score above 2 points, were included in the study. The predictive ability of the clinical factors was analyzed by comparing with the primary outcome of in-hospital mortality.
Results:
A total of 105 patients were included in the study; 58 (55.2%) male and 47 (44.8%) female patients, with median age 78 years (range, 65-96 years). Of these, 89 (84.8%) patients were independently ambulatory before presentation. The median SOFA score was 3 (2-12), and 20 (19%) patients had expired in the hospital. Logistic regression revealed that inability of ambulation is not predictive of mortality (odds ratio, 0.872; 95% confidence Interval, 0.176-4.309; P=0.866). However, correlation analysis with the SOFA score revealed an association with inability of ambulation (r=0.277, P=0.004), and multiple regression analysis also showed that ambulation affects the SOFA score (t=2.435, P=0.017; t=-2.521, P=0.013).
Conclusion:
Inability of ambulation does not predict in-hospital mortality, but affects the SOFA score of elderly patients afflicted with sepsis or in septic shock.
Key words: Sepsis; Frailty; Aged; Walking; Prognosis
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