Abstract: Objective To analyze the clinical characteristics, laboratory test characteristics and prognosis of the elderly patients with sepsis-related hemophagocyic lymphohistiocytosis (HLH), and to provide evidence for early detection and reduction of mortality. Methods The clinical information of 32 elderly patients with sepsis-related HLH (aged group) and 24 non-elderly patients with sepsis-related HLH (non-aged group) from June 2013 to March 2022 in Nanjing First Hospital were retrospectively collected. The clinical characteristics and mortality of the two groups were analyzed and compared. Results The proportion of the patients with hypertension and cerebrovascular diseases was significantly higher and the survival time was shorter in the aged group than that in the non-aged group. The 28-day mortality rate and 90-day mortality rate in the aged group were higher than those in the non-aged group (62.5% vs 25.0%, 81.3% vs 45.8%, P<0.05), and there were significant differences in the levels of blood urine nitrogen (BUN), serum creatinine (SCr), Cystatin C (CysC) and Troponin T (TnT ) between the two groups (P<0.05). The aged group had a higher incidence rate of hepatosplenomegaly compared with the non-aged group (66.7% vs 25.0%, P<0.05). There was no significant difference in mortality due to different treatment regimens containing hormones between the two groups (P>0.05). Conclusions Sepsis-related HLH in the elderly patients has a higher mortality rate and is prone to causing heart and renal damage. Early detection and early treatment are crucial to reduce the mortality rate of the patients.

Key words: hemophagocytic syndrome, organ injury, early diagnosis, prognosis