Chinese emergency expert consensus on the diagnosis and treatment of sepsis-associated encephalopathy in the elderly

Abstract

Sepsis-associated encephalopathy (SAE) is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the central nervous system. The elderly (≥65 years of age) are a particularly vulnerable population, and the emergency department is typically the first point of contact after onset. Clinical symptoms in elderly patients with SAE are often atypical, compounded by a high burden of underlying diseases and complications, which frequently leads to underdiagnosis or misdiagnosis. These patients are at an increased risk of long-term or permanent central nervous system impairment, making rapid and accurate diagnosis and treatment especially critical. Currently, there are no standardized diagnostic or treatment guidelines tailored specifically to geriatric SAE. This expert consensus, grounded in evidence-based medicine and clinical experience, offers recommendations on the risk factors, clinical characteristics, diagnosis, and treatment of geriatric SAE. The goal is to standardize care, improve diagnostic accuracy, reduce mortality, and enhance patient outcomes.

Keywords

Elderly / Emergency / Sepsis-associated encephalopathy

Author contributions

Lv C, Zhang G, Xie M, Ma Y, Gu W, and Guo W contributed to the study design. Gu W, Zhong J, Han Y, and Liu Y contributed to literature review and the draft of the manuscript.

Funding

This work was supported by Beijing Clinical Key Specialty Project (2023) and Sanming Project of Medicine in Shenzhen (No. SZZYSM202411012).

Ethical approval of studies and informed consent

Not applicable.

Acknowledgments

We thank Phoebe Chi, MD, from Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing a draft of this manuscript.

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