Early recognition and prompt treatment of a serious infection is important to optimize prognosis in older patients. The current evidence base underpinning this early recognition in ambulatory care is scattered and haphazard, calling for new research to strengthen clinical practice. Before embarking on such studies, it is important to seek consensus on what constitutes a serious infection in older patients presenting to ambulatory care. We conducted a 4-round e-Delphi study seeking consensus among medical professionals who deliver clinical care to older patients using online questionnaires and feedback. Twenty-two specialists in emergency care, general practice, geriatrics, and infectious diseases from 10 different countries participated in our study. We constructed 18 statements from the answers to the open questions in round 1, which were then rated by the participants in 2 consecutive rounds. After assessing the level of agreement, consensus, and stability, the following definition was preferred by 94% of the participants: "A serious infection in a geriatric patient presenting to ambulatory care is an infection with a high risk of complications, functional decline, and/or mortality, requiring a prompt diagnostic and therapeutic approach in the appropriate care setting. The most important determinants of the choice of setting are the level of emergency, the geriatric profile of the patient (frailty status, functional status, and comorbidities), and the patients' level of autonomy and personal preferences. Factors such as the feasibility of home care, the potential consequences of delayed or suboptimal treatment and infection specific treatment requirements should be weighed as well when choosing the appropriate care setting." Based on consensus among 22 clinicians working in 10 different countries, we propose a definition for serious infections in geriatric patients presenting to ambulatory care. This will form the basis of future studies in this domain.

中文翻译：

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就诊于门诊的老年患者严重感染的国际共识定义

早期识别和及时治疗严重感染对于优化老年患者的预后很重要。当前支持这种对门诊医疗早期认识的证据基础是分散和随意的，需要新的研究来加强临床实践。在开始此类研究之前，重要的是要就门诊老年患者的严重感染的构成寻求共识。我们进行了一项为期 4 轮的 e-Delphi 研究，在使用在线问卷和反馈为老年患者提供临床护理的医疗专业人员中寻求共识。来自 10 个不同国家的 22 名急诊、全科、老年病学和传染病专家参与了我们的研究。我们从第一轮开放问题的答案中构建了 18 个陈述，然后由参与者在连续 2 轮中对其进行评分。在评估一致性、共识和稳定性的水平后，94% 的参与者更喜欢以下定义：“就诊于门诊护理的老年患者的严重感染是一种具有并发症、功能下降和/ 或死亡率，需要在适当的护理环境中采取及时的诊断和治疗方法。选择环境的最重要决定因素是紧急程度、患者的老年情况（虚弱状态、功能状态和合并症），以及患者的自主程度和个人喜好。家庭护理的可行性等因素，