Current Epidemiology of Septic Shock

Annane, Djillali; Aegerter, Philippe; Jars-Guincestre, M C; Guidet, Bertrand

doi:10.1164/rccm.2201087

Cited by 569 publications

(387 citation statements)

References 30 publications

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“…The overall mortality rate in patients with sepsis in our study was 42.5%, while the mortality rate in patients with septic shock was 22.3%. These rates are consistent with those reported worldwide [21,22]. In total, 51.7% of patients had sepsis criteria among those hospitalized in the ICU during the study period.…”

Section: Discussionsupporting

confidence: 91%

“…Many studies have shown that mortality associated with shock ranges from 20%-70%. This wide range varies according to factors such as underlying diseases, sex, and the presence of acute respiratory distress syndrome (ARDS) [19][20][21]. Therefore, the Surviving Sepsis Campaign aims to prevent the development of sepsis and shock and to treat shock as soon as possible once it develops.…”

Section: Discussionmentioning

confidence: 99%

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Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Burunsuzoglu¹,

Saltürk²,

Karakurt³

et al. 2016

Turk Toraks Dergisi

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OBJECTIVES:The objective of this study was to evaluate the intensive care unit (ICU) and long-term mortality in sepsis patients with/ without thrombocytopenia on the fifth day of ICU admission. MATERIALS AND METHODS:The retrospective observational cohort study was performed in a teaching hospital, and patients with sepsis who stayed more than 4 days in the ICU between January 2012 and December 2012 were included. Patients were divided into two groups according to thier platelet count at fifth day of ICU stay: Group 1, < 150.000/μL; Group 2, >150.000/μL. Patients having thrombocytopenia on admission were excluded. The patients' characteristics, comorbid diseases, body mass index, arterial blood gas analysis and blood biochemistry results, SIRS criteria, Acute Physiological and Chronic Health Evaluation Score II (APACHE II), implication of invasive and non-invasive mechanical ventilation, use of sedation, nutrition information, and culture results of microbiological samples were recorded. The groups were compared according to the recorded data. Logistic regression analysis was performed for ICU mortality; the Kaplan-Meier test was used to evaluate 12-month survival after ICU discharge. RESULTS:During the period, 1003 patients were admitted to the ICU; 307 sepsis patients were included in the study. Group 1 (n= 67) and Group 2 (n=240) had similar patient characteristics and sepsis findings. The groups had similar ICU and hospital stays; mortality was higher in Group 1 than in Group 2 (40.3% vs. 17.5%, respectively, p< 0.001). Fifth day thrombocytopenia, septic shock, male gender, and low albumin levels were found to be risk factors of ICU mortality; the respective odds ratios, 95% confidence intervals, and p values for these factors were 3.03, [1.15-7.45 CONCLUSION:Higher rates of septic shock and mortality were seen in sepsis patients with thrombocytopenia in the ICU. The measurement of thrombocytopenia in the ICU, which is easy and low-cost, may help to predict mortality. Thus, precautions can be taken early in patient treatment and follow-up. As we know, early intervention is crucial in the approach to sepsis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Burunsuzoglu¹,

Saltürk²,

Karakurt³

et al. 2016

Turk Toraks Dergisi

View full text Add to dashboard Cite

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“…The occurrence and development of sepsis are associated with infection, inflammation, immune dysfunction, and blood coagulation disorders, involving the activation of numerous cells, inflammatory mediators, and the blood coagulation system. Despite modern antibiotic therapy, mortality rates for septic shock remain high (Annane et al 2003;Christaki and Opal 2008). Identifying patients who are at an increased risk of death due to sepsis is crucial for making appropriate and timely interventions to reduce mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Plasma Monocyte Chemoattractant Protein 1 as a Predictive Marker for Sepsis Prognosis: A Prospective Cohort Study

Zhu

Liao

Feng

et al. 2017

Tohoku J. Exp. Med.

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Sepsis is a systemic host response to infection, and patients with sepsis are frequently handled in the intensive care unit. However, mortality related to sepsis remains high throughout the world. In addition, there have been no efficient prognostic biomarkers for sepsis to be employed in clinical practice. We therefore aimed to identify prognostic biomarkers for sepsis using the chemokine/cytokine array. This study included 143 patients with sepsis, who were divided into survivor and nonsurvivor groups according to their 28-day mortality status. The cytokine array analysis was performed with plasma samples from two randomly selected patients in each sepsiofgroup. We thus identified seven cytokines with significantly and consistently different expression levels between nonsurvivors and survivors. The validity of the selected cytokines was then assessed by enzyme-linked immunosorbent assay (ELISA). We finally found monocyte chemoattractant protein 1 (MCP-1) as the most useful biomarker to distinguish the two sepsis groups; namely, non-surviving patients (n = 56) exhibited significantly higher plasma concentrations of MCP-1 compared to survivors (n = 87). MCP-1 is a CC chemokine, a potent chemoattractant that contributes to systemic inflammatory response syndrome. Areas under the receiver operating characteristic curves for prediction of 28-day mortality were 0.763 for MCP-1, 0.680 for the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, 0.64 for the Sequential Organ Failure Assessment (SOFA) score, 0.621 for procalcitonin, and 0.785 for MCP-1 plus APACHE II score. In conclusion, we propose that plasma MCP-1 is a useful biomarker in predicting outcome of sepsis.

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“…The former include targeted therapy such as anti-CD20 agents, tyrosine kinase inhibitors, and anti-vascular endothelial growth factor (VEGF) agents while the latter include the use of prophylactic colony-stimulating factors to decrease the duration of neutropenia and neutropeniarelated adverse events, and the availability of highly effective antifungal agents. Alongside this progress, the prognosis of the general population of critically ill patients has also improved which may have also influenced the outcome of cancer patients [15]. Finally, the population of cancer patients admitted to the ICU has evolved recently with many patients being admitted earlier [10] and who may be less critically ill at ICU admission or may have an acute disease process that is more likely to be treatable [5,7,8].…”

mentioning

confidence: 99%

Has survival increased in cancer patients admitted to the ICU? Yes

2014

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Intensive care unit (ICU) admission of patients with cancer has long been controversial. Studies performed in the early 1990s demonstrated high mortality rates in cancer patients admitted to the ICU, especially among those with respiratory failure requiring mechanical ventilation, neutropenic sepsis, and in hematopoietic stem cell transplant (HSCT) recipients [1, 2]. Additionally, a lack of cost-effectiveness was noted and some authors argued that denial of ICU admission could avoid futile care and unwarranted aggressive therapy in dying patients [3, 4].Over the past decade, however, studies that report prognosis and predictive factors for mortality in critically ill cancer patients have shown different results [5][6][7][8][9][10]. Although mortality remains high when compared to the general population of critically ill patients, these studies have demonstrated meaningful ICU and hospital survival rates and some of them improved survival over time [5][6][7][8]. Unadjusted ICU and hospital mortality rates have been found to decrease progressively [9]. However, these findings were mainly reported by single center cohort studies and usually involved a small number of patients [9]. A recent, prospective multicenter study of 1,011 critically ill patients with hematological malignancies [5] reported encouraging hospital, 90-day, and 1-year survival rates of 60.7, 52.5, and 43.3 %, respectively compared with the poor outcomes reported 15-20 years ago [1, 2, 5, 9]. Similarly, although hospital mortality remained high in those patients requiring mechanical ventilation (60.5 %), this mortality rate is significantly lower than the over 90 % mortality rates in mechanically ventilated cancer patients that were earlier reported [1, 2, 5]. Recent studies have also confirmed that complete or partial remission of the underlying disease, lack of comorbidities, and good performance status are associated with increased risk of survival whereas some of the usual prognostic factors such as neutropenia failed to be associated with adverse outcomes [5, 6, 10].Improved survival has also been demonstrated in subgroups of critically ill cancer patients including those with neutropenic sepsis [7], myeloma patients [10], and to a lesser extent in HSCT recipients [11]. Similarly, the outcome of cancer patients admitted to the ICU with severe sepsis or septic shock [6], acute respiratory distress syndrome (ARDS) [8], or those requiring mechanical Intensive Care Med (2014) 40:1570-1572

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Current Epidemiology of Septic Shock

Cited by 569 publications

References 30 publications

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Thrombocytopenia: A Risk Factor of Mortality for Patients with Sepsis in the Intensive Care Unit

Plasma Monocyte Chemoattractant Protein 1 as a Predictive Marker for Sepsis Prognosis: A Prospective Cohort Study

Has survival increased in cancer patients admitted to the ICU? Yes

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