2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference

Levy, Mitchell M.; Fink, Mitchell P.; Marshall, John C.; Abraham, Edward; Angus, Derek C.; Cook, Deborah J.; Cohen, Jonathan; Opal, Steven M.; Vincent, Jean‐Louis; Ramsay, Graham

doi:10.1097/01.ccm.0000050454.01978.3b

Cited by 5,105 publications

(2,985 citation statements)

References 35 publications

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“…The ICU characteristics are presented in Table 1. The JSEPTIC DIC study included 3,195 consecutive adult patients with severe sepsis or septic shock, which was defined on the basis of the International Sepsis Definitions Conference criteria,22 diagnosed between January 2011 and December 2013. The JSEPTIC DIC study excluded patients who were <16 years old or patients who developed severe sepsis or septic shock following ICU admission.…”

Section: Basic Information Regarding the Jseptic Dic Studymentioning

confidence: 99%

A summary of the Japan septic disseminated intravascular coagulation study

Hayakawa

Ono

2018

Acute Medicine & Surgery

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Over the past few decades, the large, international, randomized controlled trials of anticoagulant therapies for patients with sepsis have not yielded any improvement in mortality rates. However, in Japan, anticoagulant therapies are administered for sepsis patients with disseminated intravascular coagulation (DIC), but not for sepsis patients without DIC. Furthermore, epidemiological data regarding sepsis in Japan are scarce. Therefore, a nationwide multicenter retrospective observational study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study, was undertaken. The JSEPTIC DIC study enrolled 42 intensive care units and included 3,195 patients with sepsis. The results of the JSEPTIC DIC study indicated the following: (i) anticoagulant therapy may be effective in sepsis‐induced DIC patients at high risk for death, (ii) recombinant human soluble thrombomodulin administration and antithrombin supplementation are associated with survival benefits in patients with sepsis‐induced DIC.

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Section: Basic Information Regarding the Jseptic Dic Studymentioning

confidence: 99%

A summary of the Japan septic disseminated intravascular coagulation study

Hayakawa

Ono

2018

Acute Medicine & Surgery

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“…We looked at patients with sepsis compared with three control groups: adults not currently in hospital, patients in hospital with non-sepsis infection, and patients in hospital with an acute sterile inflammatory process. These comparisons allowed us to determine the excess mortality associated with sepsis (including that associated with admission to hospital) and the incremental excess mortality associated with sepsis, beyond what is associated with admission for the two cardinal features of sepsis11 13 14: infection (by comparing sepsis with inflammatory conditions not caused by infection) and inflammation (by comparing sepsis with infections without evidence of inflammatory storm).…”

Section: Introductionmentioning

confidence: 99%

Late mortality after sepsis: propensity matched cohort study

Prescott

Osterholzer

Langa

et al. 2016

BMJ

265

214

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Objectives To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself.Deign Observational cohort study.Setting US Health and Retirement Study.Participants 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage who were admitted to hospital with sepsis. Patients were matched to 777 adults not currently in hospital, 788 patients admitted with non-sepsis infection, and 504 patients admitted with acute sterile inflammatory conditions.Main outcome measures Late (31 days to two years) mortality and odds of death at various intervals.Results Sepsis was associated with a 22.1% (95% confidence interval 17.5% to 26.7%) absolute increase in late mortality relative to adults not in hospital, a 10.4% (5.4% to 15.4%) absolute increase relative to patients admitted with non-sepsis infection, and a 16.2% (10.2% to 22.2%) absolute increase relative to patients admitted with sterile inflammatory conditions (P<0.001 for each comparison). Mortality remained higher for at least two years relative to adults not in hospital.Conclusions More than one in five patients who survives sepsis has a late death not explained by health status before sepsis.

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“…8 JAAM‐SR‐Advanced also reported that the mortality rate of patients with septic shock was twice as high as those without it. 9 Nevertheless, the definition of septic shock is “refractory hypotension remaining after adequate fluid resuscitation,”14 and there is subjective discretion with regard to the amount and interval of “adequate fluid resuscitation.” Based on our results, this new outcome indicator, which combines initial hypotension and hyperlactemia ≥4 mmol/L, is thought to be objective and potentially more reliable and useful than the term “septic shock.” Furthermore, if we can utilize the initial lactate values instead of the worst lactate values over 24 h, it would be possible to predict patient outcomes more precisely at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

“…Definitions of severe sepsis and septic shock were according to the 2003 revision of the definitions by the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference 13, 14. Initial hypotension was defined as a systolic blood pressure (SBP) <90 mmHg or a MBP <65 mmHg 14…”

Section: Methodsmentioning

confidence: 99%

Early evaluation of severity in patients with severe sepsis: a comparison with “septic shock” — subgroup analysis of the Japanese Association for Acute Medicine Sepsis Registry (JAAM‐SR)

Tarui

Yamaguchi

Suzuki³

et al. 2017

Acute Medicine & Surgery

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AimThe purpose of this subgroup analysis of a Japanese multicenter registry, the Japanese Association for Acute Medicine Sepsis Registry Advanced (JAAM‐SR‐Advanced), was to identify early outcome indicators for severe sepsis that are useful and more objective than “septic shock.”MethodsAmong 624 patients with severe sepsis registered in JAAM‐SR‐Advanced, 554 with valid serum lactate data were retrospectively studied. Hypotension before and after fluid resuscitation and the highest lactate values over the initial 24 h were compared for their ability to predict in‐hospital mortality.ResultsOf the study group, 155 (28.0%) patients were non‐survivors and had significantly lower systolic blood pressures and higher lactate peaks. The mortality of 364 patients with initial hypotension was higher than those patients without it (32.7% versus 19.1%, P < 0.01). Patients with the worst lactate values ≥4 mmol/L had much higher mortality than other patients (P < 0.001). In an attempt to predict outcomes, we combined initial hypotension and the worst lactate values. The patient group with initial hypotension and the worst lactate values ≥4 mmol/L (183 patients, 33.0%) had a significantly higher mortality rate of 48.6% than the other groups (P < 0.01).ConclusionThe novel combined criterion of initial hypotension and the worst lactate values ≥4 mmol/L within the initial 24 h is potentially useful as a single outcome predictor for severe sepsis.

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2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference

Cited by 5,105 publications

References 35 publications

A summary of the Japan septic disseminated intravascular coagulation study

A summary of the Japan septic disseminated intravascular coagulation study

Late mortality after sepsis: propensity matched cohort study

Early evaluation of severity in patients with severe sepsis: a comparison with “septic shock” — subgroup analysis of the Japanese Association for Acute Medicine Sepsis Registry (JAAM‐SR)

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