Epidemiology of Sepsis Syndrome in 8 Academic Medical Centers

Sands, Kenneth; Bates, David W.; Lanken, Paul N.; Graman, Paul S.; Hibberd, Patricia L.; Kahn, Katherine L.; Parsonnet, Jeffrey; Panzer, Robert J.; Orav, E. John; Snydman, David R.; Black, Edgar; Schwartz, Joel; Moore, Richard D.; Johnson, B. Lamar; Platt, Richard

doi:10.1097/00132586-199808000-00010

Cited by 85 publications

(103 citation statements)

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“…Sepsis and septicemia were considered to refer to a number of ill-defined clinical condi-tions in addition to bacteremia, and in practice, the terms were often used interchangeably. However, fewer than one-half of the patients who have signs and symptoms of sepsis have positive blood culture (BC) results or other microbiological proof of an infectious focus (42,81,239,288). William Osler (1849 to 1919) was the first to recognize the important role of the host response in sepsis: "except on few occasions, the patient appears to die from the body's response to infection rather than from the infection."…”

Section: Historical Development Of the Understanding Of Sepsismentioning

confidence: 99%

New Approaches to Sepsis: Molecular Diagnostics and Biomarkers

et al. 2012

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SUMMARY Sepsis is among the most common causes of death in hospitals. It arises from the host response to infection. Currently, diagnosis relies on nonspecific physiological criteria and culture-based pathogen detection. This results in diagnostic uncertainty, therapeutic delays, the mis- and overuse of antibiotics, and the failure to identify patients who might benefit from immunomodulatory therapies. There is a need for new sepsis biomarkers that can aid in therapeutic decision making and add information about screening, diagnosis, risk stratification, and monitoring of the response to therapy. The host response involves hundreds of mediators and single molecules, many of which have been proposed as biomarkers. It is, however, unlikely that one single biomarker is able to satisfy all the needs and expectations for sepsis research and management. Among biomarkers that are measurable by assays approved for clinical use, procalcitonin (PCT) has shown some usefulness as an infection marker and for antibiotic stewardship. Other possible new approaches consist of molecular strategies to improve pathogen detection and molecular diagnostics and prognostics based on transcriptomic, proteomic, or metabolic profiling. Novel approaches to sepsis promise to transform sepsis from a physiologic syndrome into a group of distinct biochemical disorders and help in the development of better diagnostic tools and effective adjunctive sepsis therapies.

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Section: Historical Development Of the Understanding Of Sepsismentioning

confidence: 99%

New Approaches to Sepsis: Molecular Diagnostics and Biomarkers

et al. 2012

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“…Sepsis is the leading cause of mortality in noncoronary intensive care units worldwide (40) Although some clinical studies report a positive correlation between mortality in the medical intensive care unit and BMI (41), a recent meta analysis of critically ill patients in both medical and surgical intensive care units shows no such correlation between obesity and increased mortality (42). Notwithstanding the controversy that surrounds the link between obesity and morbidity/mortality in septic patients, animal studies are generally consistent with exaggerated inflammatory and tissue injury responses to sepsis in obese mice, compared with their lean counterparts.…”

Section: Obesity Inflammation and Organ Dysfunctionmentioning

confidence: 99%

Adipose tissue: A motor for the inflammation associated with obesity

Vachharajani¹,

Granger²

2009

IUBMB Life

127

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SummaryObesity is a worldwide epidemic that continues to grow at an alarming rate. This condition increases the morbidity and mortality associated with both acute and chronic diseases. Some of the deleterious consequences of obesity have been attributed to its induction of a low-grade chronic inflammatory state that arises from the production and secretion of inflammatory mediators from the expanded pool of activated adipocytes. This review focuses on the mechanisms that underlie the proposed link between obesity and inflammation, and it addresses how obesity-induced inflammation may account for increased morbidity and mortality that is associated with a diverse group of diseases.2009 IUBMB IUBMB Life, 61(4): [424][425][426][427][428][429][430] 2009

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“…Several retrospective series have shown that up to 85% of those who develop urosepsis and shock had underlying obstruction (due to ureteric calculi in most patients) [3][4][5]. The associated mortality rates for septic shock can be up to 50% [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Retrograde ureteric stent insertion in the management of infected obstructed kidneys

et al. 2015

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ObjectivesTo quantify the outcomes of retrograde ureteric stenting in the setting of infected hydronephrosis secondary to ureteric calculi. Patients and MethodsProspective analysis of all patients over a 15-month period admitted with infected obstructed kidneys secondary to ureteric calculi. Inclusion criteria were based on clinical evidence of systemic inflammatory response syndrome (SIRS) and radiological evidence of obstructing ureteric calculi. Outcome measures included success of procedure, admission to intensive care unit (ICU), length of hospital stay, morbidity, and all-cause mortality during hospital admission. ResultsIn all, 52 patients were included. Success of retrograde ureteric stenting was 98%. In all, 17% of patients required an ICU admission, with a post ureteric instrumentation ICU admissions rate of 6%. The mean white cell count and serum creatinine improved significantly after the procedure. Major complication rate included septic shock 6%, but there were no episodes of major haemorrhage and no deaths. ConclusionRetrograde ureteric stenting is safe and effective in infected obstructed kidneys with results comparable to percutaneous nephrostomy tube insertion. Post instrumentation ICU admissions occur in 6% of retrograde stentings.

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Epidemiology of Sepsis Syndrome in 8 Academic Medical Centers

Cited by 85 publications

References 0 publications

New Approaches to Sepsis: Molecular Diagnostics and Biomarkers

New Approaches to Sepsis: Molecular Diagnostics and Biomarkers

Adipose tissue: A motor for the inflammation associated with obesity

Retrograde ureteric stent insertion in the management of infected obstructed kidneys

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