C54-24 Incidence of In Hospital Mortality and Its Predictors Among Elderly Patients Admitted With Sepsis at Mbarara Regional Referral Hospital Uganda

Abstract

Abstract Rationale Sepsis carries a high global mortality and morbidity burden with 48.9 million sepsis cases and accounting for 20% of all deaths.Elderly patients in high-income countries are disproportionately affected by this burden.There is limited data on outcomes of sepsis among the elderly patients in Africa. Methods We hypothesized that elderly patients with sepsis in Mbarara, Uganda would have higher in-hospital mortality rates compared to those in high-income countries. We conducted a retrospective chart review of elderly patients (aged above 65 years) who were admitted to the medical emergency ward between January 2020 and December 2024 with suspected infection and a qSOFA score of 2 and above.Data on baseline demographics,comorbidities,clinical history and findings,laboratory tests and treatment were extracted using REDCap. Multivariate Cox regression analysis was used to determine the predictors of mortality with a significance level of p < 0.05 Results A total of 351 participants were included for analysis.The patients had a mean(standard deviation) age of (77±8.7)years and 178(50.7%) were male.The most common sites of infection were respiratory 199(56.7%),genitourinary 54(15.4%) and gastrointestinal 41(11.7%). Hypertension was the commonest comorbidity 64(18.2%) followed by diabetes mellitus 39(11.1%) and HIV (Human immunodeficiency virus) infection 39(11.1%). The in-hospital mortality rate was 5.3 per 100 person-days (95% CI,4.10-6.20) translating to 42.4%. Participants that missed admission antibiotics (aHR=2.93;95%CI 1.47-5.84; p = 0.002), having a low mean arterial pressure <65mmHg (aHR=2.18; 95%CI 1.09-5.07; p=0.03 and low oxygen saturation <90% (aHR= 1.92;95%CI 1.01-3.69;p=0.046) at admission were significantly more likely to die during hospitalization. Conclusion Elderly patients admitted with sepsis in Uganda experience high mortality during hospitalization.This is mainly propelled by modified factors at admission which can be managed to reduce mortality. This abstract is funded by: None