Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort

Mythreyi Mahalingam, Justin Xavier Moore, John P. Donnelly, Monika M. Safford, Henry E. Wang

Research output: Contribution to journalReview article

Abstract

Background: Frailty is associated with increased morbidity and mortality in older persons. We sought to characterize the associations between the frailty syndrome and long-term risk of sepsis in a large cohort of community-dwelling adults. Methods: We analyzed data on 30 239 community-dwelling adult participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We defined frailty as the presence of at least 2 frailty indicators (weakness, exhaustion, and low physical activity). We defined sepsis as hospitalization for a serious infection with ≥2 system inflammatory response syndrome criteria, identified for the period 2003-2012. We determined the associations between frailty and risk of first sepsis and sepsis 30-day case fatality. Results: Among REGARDS participants, frailty was present in 6018 (19.9%). Over the 10-year observation period, there were 1529 first-sepsis hospitalizations. Frailty was associated with increased risk of sepsis (adjusted hazard ratio [HR] 1.44; 95% CI: 1.26 to 1.64). The total number of frailty indicators was associated with increased risk of sepsis (P trend <.001). Among first-sepsis hospitalizations, frailty was associated with increased sepsis 30-day case fatality (adjusted OR 1.62; 95% CI: 1.06 to 2.50). Conclusions: In the REGARDS cohort, frailty was associated with increased long-term risk of sepsis and sepsis 30-day case fatality.

Original languageEnglish (US)
Pages (from-to)292-300
Number of pages9
JournalJournal of Intensive Care Medicine
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2019
Externally publishedYes

Fingerprint

Systemic Inflammatory Response Syndrome
Sepsis
Stroke
Independent Living
Hospitalization
Observation
Exercise

Keywords

  • epidemiology
  • frailty
  • infection
  • sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort. / Mahalingam, Mythreyi; Moore, Justin Xavier; Donnelly, John P.; Safford, Monika M.; Wang, Henry E.

In: Journal of Intensive Care Medicine, Vol. 34, No. 4, 01.04.2019, p. 292-300.

Research output: Contribution to journalReview article

Mahalingam, Mythreyi ; Moore, Justin Xavier ; Donnelly, John P. ; Safford, Monika M. ; Wang, Henry E. / Frailty Syndrome and Risk of Sepsis in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort. In: Journal of Intensive Care Medicine. 2019 ; Vol. 34, No. 4. pp. 292-300.
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AB - Background: Frailty is associated with increased morbidity and mortality in older persons. We sought to characterize the associations between the frailty syndrome and long-term risk of sepsis in a large cohort of community-dwelling adults. Methods: We analyzed data on 30 239 community-dwelling adult participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We defined frailty as the presence of at least 2 frailty indicators (weakness, exhaustion, and low physical activity). We defined sepsis as hospitalization for a serious infection with ≥2 system inflammatory response syndrome criteria, identified for the period 2003-2012. We determined the associations between frailty and risk of first sepsis and sepsis 30-day case fatality. Results: Among REGARDS participants, frailty was present in 6018 (19.9%). Over the 10-year observation period, there were 1529 first-sepsis hospitalizations. Frailty was associated with increased risk of sepsis (adjusted hazard ratio [HR] 1.44; 95% CI: 1.26 to 1.64). The total number of frailty indicators was associated with increased risk of sepsis (P trend <.001). Among first-sepsis hospitalizations, frailty was associated with increased sepsis 30-day case fatality (adjusted OR 1.62; 95% CI: 1.06 to 2.50). Conclusions: In the REGARDS cohort, frailty was associated with increased long-term risk of sepsis and sepsis 30-day case fatality.

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