Management is largely based on standard international guidelines with a few modifications.
Age itself is an independent risk factor for death in patients with severe sepsis, however, many patients respond well to timely and appropriate interventions.
Indeed, the time to initiate therapy is thought to be crucial and the major determent factor in surviving sepsis.
Despite substantial progress in sepsis therapy, the gap between the discovery of new effective medical molecules and their implementation in the daily clinical practice of the intensive care unit remains a major hurdle.
Indeed, we need to revisit current paradigms and to think about the possibility that outcome may be predetermined in severe sepsis or septic shock.
In addition, an early diagnosis of sepsis prior to the onset of clinical decline is also of particular interest to health practitioners because this information increases the possibilities for early and specific treatment of this life threatening condition.
On this basis, new therapies could be tested to reduce mortality rates with respect to recently published studies.
Introduction: Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised controlled trials (RCT).
However, the incidence of severe sepsis in older patients was 26.2 cases per 1000 population.
Bayesian outcome probabilities were calculated as the probability (P) that OR ≥1. High-dose (1000 mg hydrocortisone (equivalent) per day) corticosteroid trials were associated with a null (n = 5; OR 0.91(0.31-1.25)) or higher (n = 4, OR 1.46(0.73-2.16), outlier excluded) mortality probability (P = 42.0% and 89.3%, respectively).
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers.
Despite advances in the management of septic patients, sepsis is still the second leading cause of death among patients in non-coronary ICUs.
The incidence and prevalence of sepsis increase with age.