In critically ill nonagenarians and centenarians admitted to ICUs with septic shock, the source of infection emerges as a key independent predictor of long-term survival, varying over time. Patients with septic shock from non-urinary sources faced significantly higher 300-day mortality compared to those with urinary tract origins, even when initial illness severity was similar.

This difference emphasizes the need to include infection source in early risk assessment, triage, and discussions about goals of care.
Simple bedside markers like urine output and arterial pH further improve prognostic accuracy, helping identify higher-risk cases.

As the number of very elderly patients requiring intensive care rises, integrating infection source and early physiological signs into tailored tools will enable more personalized decision-making and resource allocation in critical care.

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