Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study

Karlsson, Sari; Varpula, Marjut; Ruokonen, Esko; Pettilä, Ville; Parviainen, Ilkka; Ala‐Kokko, Tero; Kolho, Elina; Rintala, Esa

doi:10.1007/s00134-006-0504-z

Cited by 211 publications

(191 citation statements)

References 36 publications

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“…(49.7%) [28], but higher than that reported in the Finnsepsis study (28.3%) [29]. The impact on mortality of nosocomial sepsis versus community-acquired sepsis was similar to the recently published results of Alberti et al [16].…”

Section: Discussionsupporting

confidence: 81%

Sepsis mortality prediction based on predisposition, infection and response

et al. 2007

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Objective: To empirically test, based on a large multicenter, multinational database, whether a modified PIRO (predisposition, insult, response, and organ dysfunction) concept could be applied to predict mortality in patients with infection and sepsis. Design: Substudy of a multicenter multinational cohort study (SAPS 3). Patients: A total of 2,628 patients with signs of infection or sepsis who stayed in the ICU for > 48 h. Three boxes of variables were defined, according to the PIRO concept. Box 1 (Predisposition) contained information about the patient's condition before ICU admission. Box 2 (Injury) contained information about the infection at ICU admission. Box 3 (Response) was defined as the response to the infection, expressed as a Sequential Organ Failure Assessment score after 48 h. Interventions: None. Main measurements and results: Most of the infections were community acquired (59.6%); 32.5% were hospital acquired. The median age of the patients was 65 (50-75) years, and 41.1% were female. About 22% (n = 576) of the patients presented with infection only, 36.3% (n = 953) with signs of sepsis, 23.6% (n = 619) with severe sepsis, and 18.3% (n = 480) with septic shock. Hospital mortality was 40.6% overall, greater in those with septic shock (52.5%) than in those with infection (34.7%). Several factors related to predisposition, infection and response were associated with hospital mortality. Conclusion: The proposed three-level system, by using objectively defined criteria for risk of mortality in sepsis, could be used by physicians to stratify patients at ICU admission or shortly thereafter, contributing to a better selection of management according to the risk of death.

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Section: Discussionsupporting

confidence: 81%

Sepsis mortality prediction based on predisposition, infection and response

et al. 2007

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“…17,18 Although the likelihood of a culture that shows growth of microorganisms increases in proportion to the severity of the infection, blood cultures that show growth are obtained from only around 40% of patients with severe sepsis or septic shock. 17,19 According to previous studies, the use of PCR diagnostic techniques such as SeptiFast could help increase this percentage significantly. 10,11,20,21 In this study, we observed that blood cultures that showed growth were obtained in only 28.6% of the evaluated patients, which is largely consistent with the findings reported for other studies.…”

Section: Discussionmentioning

confidence: 99%

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

Suberviola

Márquez-López

Castellanos-Ortega

et al. 2015

American Journal of Critical Care

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Objective To compare the utility of a multiplex polymerase chain reaction system (SeptiFast) and blood cultures for detecting bacteria and fungi in blood samples from patients with severe sepsis or septic shock. Methods In a prospective observational study, whole blood samples for SeptiFast testing and for culture were collected on admission from all patients with severe sepsis or septic shock admitted to the intensive care unit between July 2011 and September 2012. SeptiFast results were compared with blood and other culture results. Results The probability of at least 1 microorganism being isolated at 6 hours was 13-fold higher with the SeptiFast test than with blood cultures (relative risk, 13.5; 95% CI, 5.05-36.06). Unlike culture results, SeptiFast test results were not associated with previous antibiotic consumption. The median time to the first positive blood culture result was 17 hours; SeptiFast results were available in 6 hours. SeptiFast detected genetic material from potentially multiresistant microorganisms in patients whose blood cultures showed no growth at all. Conclusions The SeptiFast test provided quicker microbiological diagnosis and identified significantly more microorganisms than blood cultures did, particularly when samples were collected after antibiotic therapy had started or infections were due to resistant bacteria and yeast.

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“…A recent meta‐analysis of RCTs reported that the survival benefit of anticoagulant therapy was observed only in sepsis patients with DIC, but not in those without DIC 10. Furthermore, although many epidemiological studies for sepsis have been carried out,11, 12, 13, 14, 15 epidemiological data regarding sepsis in Japan is limited 16, 17…”

Section: Introductionmentioning

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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Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study

Cited by 211 publications

References 36 publications

Sepsis mortality prediction based on predisposition, infection and response

Sepsis mortality prediction based on predisposition, infection and response

Microbiological Diagnosis of Sepsis: Polymerase Chain Reaction System Versus Blood Cultures

A summary of the Japan septic disseminated intravascular coagulation study

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