Possible Ageism in the Aggressiveness of Severe Sepsis Treatment

Sepsis is an emerging concern among older adults, associated with high mortality. Evidence of possible ageism, in the form of less aggressive treatment, has been reported for other diseases. The goal of the study was to investigate whether age was a determining factor in aggressiveness of treatment for severe sepsis and to evaluate in-hospital mortality rates. A subanalysis of previously collected data was performed. This database contained 143 adult patients admitted to a 760-bed tertiary care teaching hospital from June 2004 to May 2005 with a diagnosis of severe sepsis and/or septic shock. Aggressiveness of treatment was measured by rates of compliance with the Society of Critical Care Medicine (SCCM) treatment guidelines and activation of the hospital’s sepsis response team (SRT). There were 73 patients in the older adult group (≥ 65 years) and 62 in the younger adult group (18 – 64 years). SRT was activated less often for older adults (19% vs. 41%, p = 0.008), but treatment compliance rates were similar. In-hospital mortality was higher in the older adult group, 51% vs. 27%, p = 0.008, despite similar treatment compliance rates. The decision to activate the SRT is one indicator of aggressiveness of treatment. Neither age nor activation of the SRT appeared to be correlated with treatment compliance. Although treatment compliance was similar between groups, mortality was higher in the older adults.