{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:49:38Z","timestamp":1785761378065,"version":"3.56.0"},"reference-count":22,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,21]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare clinical outcomes between urinary and non-urinary tract sepsis in nonagenarians and centenarians admitted to intensive care units (ICUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective propensity score-matched multicentre cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Adult ICUs participating in the Australian and New Zealand Intensive Care Society Adult Patient Database across Australia and New Zealand (2010\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We included all ICU admissions for sepsis in patients aged 90 years or older, classified as urinary or non-urinary tract sepsis using Acute Physiology and Chronic Health Evaluation III-J diagnostic codes. After 1:1 nearest neighbour propensity score matching, 1130 patients (565 per group) were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was all-cause mortality within 180 days and beyond 180 days. Secondary outcomes included ICU mortality, hospital mortality, ICU length of stay and hospital length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1669 patients, 573 had urinary tract sepsis and 1096 had non-urinary tract sepsis. After matching, 1130 patients were included (565 per group). In the matched cohort, non-urinary tract sepsis was associated with higher mortality within 180 days than urinary tract sepsis (HR 1.67, 95% CI 1.33 to 2.09, p&lt;0.001), whereas mortality beyond 180 days did not differ (HR 1.03, 95% CI 0.80 to 1.34, p=0.816). ICU and hospital length of stay were similar between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among nonagenarian and centenarian ICU patients with sepsis, infection source was an important determinant of early but not late mortality, with non-urinary tract sepsis conferring a higher risk than urinary tract sepsis. Incorporating infection source and simple physiological markers alongside illness severity scores may improve prognostication and support shared decision-making in this very old population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114774","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:05:43Z","timestamp":1785758743000},"page":"e114774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sepsis of urinary vs non-urinary tract origin in nonagenarians and centenarians admitted to Australian and New Zealand intensive care units: a propensity-matched multicentre cohort analysis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0083-8905","authenticated-orcid":false,"given":"Je Min","family":"Suh","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-7680","authenticated-orcid":false,"given":"Laurence","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia"},{"name":"Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaden","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1212-2115","authenticated-orcid":false,"given":"Nattaya","family":"Raykateeraroj","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pilcher","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, The Alfred Hospital, Prahran, Victoria, Australia"},{"name":"Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society (ANZICS), Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-2363","authenticated-orcid":false,"given":"Dong-Kyu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026080305052036000_16.8.e114774.1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.ccm.2022.05.003","article-title":"Advances in Sepsis Care","volume":"43","author":"Jackson","year":"2022","journal-title":"Clin Chest Med"},{"key":"2026080305052036000_16.8.e114774.2","unstructured":"Australian Commission on Safety and Quality in Health Care . Epidemiology of sepsis in australia. Sydney ACSQHC; 2020. Available: https:\/\/www.safetyandquality.gov.au\/sites\/default\/files\/2020-05\/epidemiology_of_sepsis_-_february_2020_002.pdf"},{"key":"2026080305052036000_16.8.e114774.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-023-10223-1","article-title":"Sepsis-coded hospitalisations and associated costs in Australia: a retrospective analysis","volume":"23","author":"Kumar","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"2026080305052036000_16.8.e114774.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-025-05349-z","article-title":"Characteristics, outcomes, and complications among nonagenarian and centenarian patients admitted to the intensive care unit: a scoping review","volume":"29","author":"Suh","year":"2025","journal-title":"Crit Care"},{"key":"2026080305052036000_16.8.e114774.5","article-title":"Sepsis in Aging Populations: A Review of Risk Factors, Diagnosis, and Management","volume":"16","author":"Alhamyani","year":"2024","journal-title":"Cureus"},{"key":"2026080305052036000_16.8.e114774.6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ccc.2020.08.006","article-title":"The Effect of Aging Physiology on Critical Care","volume":"37","author":"Darden","year":"2021","journal-title":"Crit Care Clin"},{"key":"2026080305052036000_16.8.e114774.7","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2021.628302","article-title":"Sepsis-Pathophysiology and Therapeutic Concepts","volume":"8","author":"Jarczak","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"2026080305052036000_16.8.e114774.8","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms11081959","article-title":"Influence of Sepsis on the Middle-Term Outcomes for Urinary Tract Infections in Elderly People","volume":"11","author":"Artero","year":"2023","journal-title":"Microorganisms"},{"key":"2026080305052036000_16.8.e114774.9","doi-asserted-by":"crossref","unstructured":"Martinez RM , Wolk DM . 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