Clinical and etiological profile of sepsis in geriatric patients admitted to a tertiary care hospital in North India: a prospective observational study
Sachin Gautam, Satish Kumar, Balbir Singh Verma, Amit KumarAbstract
Background:
Sepsis remains a leading cause of morbidity and mortality worldwide, with a disproportionately greater impact on the elderly population. Age-related immunosenescence, the high prevalence of multiple comorbidities, increasing frailty, and the atypical clinical presentation of infections in older adults significantly increase susceptibility to sepsis and its associated complications. As life expectancy continues to rise and the geriatric population grows, there is an increasing need for early recognition of subtle clinical manifestations of sepsis and for the development of region-specific treatment strategies tailored to prevalent pathogens and local antimicrobial susceptibility patterns. Despite this need, region-specific epidemiological data remain limited, particularly in geographically remote, hilly regions of North India, where healthcare access is often challenging and disease patterns may differ from those observed elsewhere. Therefore, the present study was undertaken to evaluate the clinical characteristics, sources of infection, organ dysfunction, treatment requirements, and clinical outcomes of sepsis among geriatric patients admitted to a tertiary care hospital in this region.
Materials and Methods:
This prospective observational study was conducted over 1 year, from April 2024 to March 2025, in the Department of Medicine at Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. Patients aged 65 years and older who were admitted with sepsis, as defined by the Sepsis-3 criteria, were consecutively enrolled. Data on the demographic characteristics, clinical presentation, comorbidities, laboratory parameters, source of infection, microbiological profile, Sequential Organ Failure Assessment score, requirement for organ support, and in-hospital outcomes were prospectively collected and analyzed using Statistical Package for the Social Sciences version 26.
Results:
A total of 116 elderly patients with sepsis were enrolled in the study. The mean age of the participants was 70.5 ± 6.5 years, and 59.5% were men. Fever was the most common presenting symptom (75%), followed by altered mental status (35.3%) and breathlessness (32.8%). Hypertension (46.6%) and diabetes mellitus (44.8%) were the most prevalent comorbidities. The respiratory tract was the predominant source of infection (33.6%), followed by the urinary tract (28.4%). Among the pathogens isolated,
Conclusion:
Sepsis in elderly patients is associated with high mortality, substantial organ dysfunction, and a significant requirement for intensive care support. Respiratory and urinary tract infections are the most common sources of sepsis, with gram-negative bacteria being the predominant causative organisms. Owing to the frequently atypical clinical presentation in older adults, prompt recognition, early initiation of appropriate antimicrobial therapy, and timely supportive management are crucial for improving clinical outcomes in this vulnerable population.