Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people

Lee, Chien‐Chang; Yo, Chia‐Hung; Lee, Meng Tse Gabriel; Tsai, Kun-Tong; Lee, Shih Hao; Chen, Yueh Sheng; Lee, Wan Chien; Hsu, Tien-Pen; Lee, Sie Hue; Chang, Shy Shin

doi:10.1016/j.jinf.2017.08.012

Cited by 33 publications

(29 citation statements)

References 27 publications

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“…Additional file 1 shows a summary of these studies. As an Asian comparison, a nationwide epidemiological study on sepsis in Taiwan, analyzed a similar aging cohort with sepsis [ 10 ], and their results showed that diabetes mellitus (with or without complications) was the most common comorbidity, which is consistent with that of our study. This likely reflects the common characteristics of individuals in developed countries, although it remains controversial whether the severity of diabetes mellitus itself is a risk factor for sepsis [ 11 , 12 ].…”

Section: Discussionsupporting

confidence: 90%

Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study

Ogura²,

et al. 2018

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BackgroundSepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan.MethodsThis is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria.ResultsIn total, 1184 patients (median age 73 years, interquartile range (IQR) 64–81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6–11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21–26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12–46) days. Approximately 37% of the patients were discharged home after recovery.ConclusionOur prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan.Trial registrationUMIN-CTR, UMIN000019742. Registered on 16 November 2015.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2186-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study

Ogura²,

et al. 2018

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“…Annual change, % are consistent with our finding of the trend of increasing sepsis incidence with decreasing mortality [1][2][3]19]. This trend is presumably reflecting ongoing efforts to improve sepsis awareness, treatment, documentation, and coding.…”

Section: 2014supporting

confidence: 87%

Incidence, trends, and outcomes of infection sites among hospitalizations of sepsis: A nationwide study

et al. 2020

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“…Our logistic regression analysis demonstrated that several sociodemographic characteristics of the patients influenced their risk of postoperative sepsis. Being male or older (≥65 years) considerably increased the risk of developing postoperative sepsis; the elevated risk associated with these factors has been consistently reported in other epidemiological studies of sepsis [16,26,27] and postoperative sepsis [14,15]. Sex hormones play a major [31,32].…”

Section: Table 1 Continued: Basic Characteristics Of the Study Particmentioning

confidence: 77%

Epidemiological characteristics of postoperative sepsis

Chen

Luo

Chen³

et al. 2019

Open Medicine

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AbstractBackgroundPostoperative sepsis is a major type of sepsis. Sociodemographic characteristics, incidence trends, surgical procedures, comorbidities, and organ system dysfunctions related to the disease burden of postoperative sepsis episodes are unclear.MethodsWe analyzed epidemiological characteristics of postoperative sepsis based on the ICD-9-CM codes for the years 2002 to 2013 using the Longitudinal Health Insurance Databases of Taiwan’s National Health Insurance Research Database.ResultsWe identified 5,221 patients with postoperative sepsis and 338,279 patients without postoperative sepsis. The incidence of postoperative sepsis increased annually with a crude mean of 0.06% for patients aged 45–64 and 0.34% over 65 years. Patients with postoperative sepsis indicated a high risk associated with the characteristics, male sex (OR:1.375), aged 45–64 or ≥ 65 years (OR:2.639 and 5.862), low income (OR:1.390), aged township (OR:1.269), agricultural town (OR:1.266), and remote township (OR:1.205). Splenic surgery (OR:7.723), Chronic renal disease (OR:1.733), cardiovascular dysfunction (OR:2.441), and organ system dysfunctions had the highest risk of postoperative sepsis.ConclusionRisk of postoperative sepsis was highest among men, older, and low income. Patients with splenic surgery, chronic renal comorbidity, and cardiovascular system dysfunction exhibited the highest risk for postoperative sepsis. The evaluation of high-risk factors assists in reducing the disease burden.

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Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people

Cited by 33 publications

References 27 publications

Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study

Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study

Incidence, trends, and outcomes of infection sites among hospitalizations of sepsis: A nationwide study

Epidemiological characteristics of postoperative sepsis

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