Sepsis and septic shock in geriatrics

Sepsis is a potentially life-threatening condition that poses diagnostic challenges, particularly in the older population. Clinical manifestations of sepsis in these individuals can be blurred and atypical, making detection and diagnosis difficult. Common symptoms such as fever may be absent; conversely, older patients may present with atypical signs such as delirium, altered mental status, falls, weakness, and urinary incontinence. This can lead to delayed diagnosis, which increases the risk of rapid progression to septic shock. To improve diagnostic accuracy, various laboratory biomarkers and clinical scores have been developed, such as the Sequential (Sepsis-related) Organ Failure Assessment Score (SOFA-score), quick SOFA (qSOFA), and geriatric-qSOFA. These tools aid in identifying sepsis and predicting mortality risk promptly. In terms of treatment, early intervention is crucial. Maintaining adequate tissue perfusion (“fluid resuscitation”), appropriate antibiotic therapy, and eventually vasopressor support are key components of sepsis management in older adults. Additionally, in frail and comorbid patients, priority must be given to supportive care aimed at enhancing quality of life. Tailored therapeutic interventions are crucial to improving outcomes in this vulnerable population.