Sepsis in Older Patients: An Emerging Concern in Critical Care

Severe sepsis is a very common and important cause of morbidity and mortality in the older population, and its incidence has increased in the last 10 years [1]. It is estimated that about 750 000 patients per year develop severe sepsis in the US, of which nearly 60% are>65 years-of-age [2,3]. This is also reflected in the changing demographics of intensive care units (ICUs), where nearly two-thirds of beds are occupied by those>65 years old [3]. Aging patients account for 40–50% of all cases of bacteremia, and the overall case fatality rate for older patients with bacteremia ranges from 40–60%, or higher when Gram-negative organisms are involved [4,5,6]. This segment of the population will increase significantly over the coming years, driving an increase in the amount of resources used on these patients, who are thought to have a shortened life span [7]. This review analyzes the characteristics of older patients, discusses the unique aspects of severe sepsis in this increasingly important segment of our society, and provides a better understanding of the special needs of these patients. We also outline areas of future research that might improve outcomes in this patient population