1. Immunocompromised: HIV/AIDs, Cancer 2. Elderly 3. Children 4. Diabetes, Kidney/Liver disease 5. Burns/Trauma

The new guidelines facilitate early recognition (see additional topics) and thus result in improved outcomes in sepsis; which was a rising cause of death in previous years.

National Institute of General Medical Sciences. (2014). Sepsis fact sheet. Retrieved from

https://www.nigms.nih.gov/Education/pages/factsheet_sepsis.aspx

Comorbidities • 71.7% of sepsis cases consist of people that have at least 1 of the following comorbidities: diabetes, kidney disease, heart failure, cancer, chronic obstructive pulmonary disease, hypertension, liver cirrhosis and HIV

Liver Disease • Cirrhosis of the liver can increase the risk of sepsis

Kidney Failure • Studies have shown that 32-48% of acute kidney injury cases are caused by sepsis • Kidneys can be affected by sepsis in 2 ways: o The kidneys become infected  Example: a bladder infection spreads to the kidneys, resulting in a kidney infection o The kidneys fail as a result of the sepsis cascade  Example: the patient is septic and becomes hypotensive, which causes renal failure due to decreased renal perfusion

Elderly • Although sepsis can affect every age group, the very young, the very old, and those with chronic health problems are at higher risk of developing sepsis • 12% of the population are people ≥65 years old • 65% of sepsis cases are people ≥65 years old • Because elderly people have decreased ability to effectively fight infections, they are more at risk for developing sepsis • In the elderly, urinary and respiratory tract infections are the most common sites of sepsis • Signs of sepsis are consistent among all adults; however, confusion and lower than normal temperature may be more common in the elderly • Studies show that if an elderly patient survives sepsis, they are 3x as likely to have long-term cognitive abilities • The risk of death from sepsis increases with age

Symptoms of Sepsis Pneumonic • Shivering, fever, or very cold • Extreme pain or general discomfort (“worst ever”) • Pale or discolored skin • Sleepy, difficult to rouse, confused • I “I feel like I might die” • Short of breath

Reference: Sepsis Alliance. (2016). Sepsis and… Retrieved from

http://www.sepsis.org/ Contributed by: Twyla Bergenstal

Geriatric Trauma and Sepsis are influenced by:

1)The severity of their trauma injuries 2)The number of comorbidities managed 3)The length of stay in the ICU

These all significantly influence the occurrence and severity of sepsis. The leading cause of death in trauma patients >60 years old is associated with sepsis.

Pavlou, H., Pappa, E., & Eforakopoulou, M. (2015). Factors related to sepsis and outcome in multiple trauma patients. ~~Critical Care, 19(1), 318-319~~~~