RISK-FACTORS FOR SEPTICEMIA-ASSOCIATED MORTALITY IN OLDER ADULTS

Septicemia is the 10th leading cause of death among older adults in th e United States; its mortality rate has steadily increased over the pa st decades. Little is known about factors which predispose to septicem ia mortality in the elderly. The authors investigated risk factors for septicemia-associated mortality in 10,269 older adults as part of a l ongitudinal study of three communities (East Boston, MA; New Haven, CT ; and Iowa and Washington Counties, IA). During 6 years of followup, 1 77 persons (3.2 per 1,000 person-years) had septicemia ICD9 038 (Inter national Classification of Diseases, ninth revision) reported on their death certificate. In a multivariate proportional-hazards model, sept icemia mortality was significantly (P<0.05) and independently associat ed with age, male sex, history of diabetes, history of cancer requirin g hospitalization, smoking one pack of cigarettes per day or more, not drinking alcohol in the year prior to baseline, disability in activit ies of daily living, cognitive impairment, and missing cognitive testi ng score. These factors might be useful in developing an at-risk popul ation for testing septicemia treatment or prevention strategies in a c ommunity setting. Further investigation is needed to explain underlyin g mechanisms of increased risk of subsequent septicemia.