Evaluation of the clinical characteristics and risk factors for in-hospital mortality amongst older persons admitted with bacteraemia in a geriatric ward – a single tertiary centre review

Bloodstream infections in older persons are associated with greater morbidity and mortality. Older individuals often present with atypical symptoms, such as lethargy, poor oral intake, or falls, rather than classical signs like fever or localized symptoms. This study aims to evaluate the clinical characteristics of older persons admitted with bacteraemia and identify predictors of in-hospital mortality. A retrospective observational cohort study was conducted at a tertiary hospital. Patients admitted to the geriatric ward with bacteraemia over a 1.5-year study period were included in the study. Demographic, clinical, and laboratory data were collected and analyzed to identify independent predictors for in-hospital mortality. A total of 185 older patients were included in this study. Presentations were frequently non-specific, with 33.5% of the patients not fulfilling Systemic Inflammatory Response Syndrome (SIRS) criteria on admission. Advanced age (≥ 76 years old), hypalbuminaemia (< 20 g/L), elevated lactate (> 2 mmol/L), delirium, and absence of SIRS criteria were independently associated with increased in-hospital mortality of the older patients with bacteraemia. Due to immunosenescence and age-related physiological changes, older persons often present atypically and may have normal vital signs or laboratory values despite severe infection. Clinicians should maintain a high index of suspicion for sepsis in older patients, even in the absence of classical symptoms, to enable timely diagnosis and management.