Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost

Adrie, Christophe; Alberti, Corinne; Chaix-Couturier, Carine; Azoulay, Élie; Lassence, Arnaud de; Cohen, Yves; Meshaka, Patrick; Cheval, Christine; Thuong, Marie; Troché, Gilles; Garrouste-Orgeas, Maïté; Timsit, Jean‐François

doi:10.1016/j.jcrc.2004.10.005

Cited by 148 publications

(125 citation statements)

References 36 publications

Supporting

Mentioning

109

Contrasting

Unclassified

Order By: Relevance

“…Information on the risk factors of sepsis may be useful for identifying high-risk subgroups who need particular attention to prevent sepsis from developing during the ICU stay. Several studies have reported that organ dysfunction along with severity of illness and device use were significantly associated with an increased incidence of sepsis (5,7,12). Moreover, patients admitted from medical and emergency surgical wards showed a higher incidence of sepsis than those admitted from surgical wards (5,7,12); however no significant association with operation was observed in this study.…”

Section: Discussioncontrasting

confidence: 72%

“…First, organ dysfunction may be associated with the incidence and outcome of sepsis. Several studies have reported that organ dysfunction was significantly associated with an increased incidence of sepsis (5,7,12). Patients with organ dysfunction in addition to sepsis are considered to have severe sepsis or septic shock (1, 2), and therefore a higher probability of death (14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and Outcome of Sepsis in Japanese Intensive Care Units: The Japanese Nosocomial Infection Surveillance System

Suka¹,

Yoshida²,

Takezawa³

2006

Environ. Health Prev. Med.

View full text Add to dashboard Cite

Objectives: To determine the incidence of sepsis in Japanese intensive care units (ICUs) and to evaluate the impact of sepsis on mortality and length of stay (LOS).Methods: Using the JANIS database for the period between June 2002 and June 2004, 21,895 eligible patients aged ≥16 years, hospitalized in 28 participating ICUs for ≥24 hours, were monitored until ICU discharge. Adjusted hazard ratio (HR) with 95% confidence interval (CI) for the incidence of sepsis was calculated using Cox's proportional hazard model. Standardized mortality ratio (SMR) was calculated on the basis of the crude mortality in patients without nosocomial infection (NI) for respective APACHE II categories. Mean LOS for survivors was assessed by two-way analysis of variance with adjustment for APACHE II.Results: Sepsis was diagnosed in 450 patients (2.1%), with 228 meeting the definition on ICU admission and 222 during the ICU stay. The overall incidence of sepsis was 1.02/100 admissions or 2.00/1000 patient-days. A significantly higher HR for the incidence of sepsis was found in men (1.54, 95% CI: 1.14-2.07), APACHE II ≥21 (2.92, 95% CI: 1.92-4.44), ventilator use (3.30, 95% CI: 1.98-5.49), and central venous catheter use (3.45, 95% CI: 1.90-6.28). SMR was determined to be 1.18 (95% CI: 0.82-1.21) in NI patients without sepsis and 2.43 (95% CI: 1.88-3.09) in NI patients with sepsis. Mean LOS for survivors was calculated to be 11.8 days (95% CI: 11.3-12.4) in NI patients without sepsis and 15.0 days (95% CI: 13.3-17.0) in NI patients with sepsis compared with 3.8 days (95% CI: 3.8-3.9) in patients without NI.Conclusions: Sepsis is not very common in Japanese ICUs, but its development leads to further increases in mortality and LOS in patients with NI.

show abstract

Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Incidence and Outcome of Sepsis in Japanese Intensive Care Units: The Japanese Nosocomial Infection Surveillance System

Suka¹,

Yoshida²,

Takezawa³

2006

Environ. Health Prev. Med.

View full text Add to dashboard Cite

show abstract

“…Sepsis represents a substantial high-cost healthcare burden 1 and there is limited epidemiological information about the demography of sepsis or about the temporal changes in its incidence and outcome. The occurrence of sepsis in the United States from 1979 to 2000 using a nationally representative sample showed that the incidence and number of sepsis-related deaths increased, despite a decline in the overall in-hospital mortality among sepsis patients 17 .…”

mentioning

confidence: 99%

Comparative study of survivor and nonsurvivor sepsis patients in a university hospital

Oliveira

Barata

Murta

et al. 2008

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

To determine parameters associated with the evolution of sepsis, a five-year retrospective study was conducted in a university hospital. One hundred and four consecutive sepsis patients were evaluated, of whom 55.8% were men. The mortality was 68.3% and was associated with older age (p<0.05). Chronic comorbidities and infection site were not associated with prognosis. Gram-positive bacteria were more frequently identified in survivors (p<0.05), while non-detection of the germ was associated with mortality (p<0.01). Appropriate use of antibiotics (germ sensitive to at least one drug administered) was associated with survival (p<0.0001) while inappropriate use (p<0.05) or empirical use (p<0.01) were more frequent in nonsurvivors. Leukocytosis was the main abnormality (54.8%) detected on diagnosis, from the leukocyte count. During the evolution, normal leukocyte count was associated with survival (p<0.01) and leukocytosis with mortality (p<0.05). In conclusion, mortality was associated with nondetection of the pathogen, leukocytosis during the evolution of the sepsis and inappropriate or empirical use of antimicrobials. Evidence-based treatment that is directed towards modifiable risk factors might improve the prognosis for sepsis patients.Key-words: Sepsis. Prognosis. Antimicrobials. Risk factors. RESUMOPara determinar parâmetros associados à evolução da sepse, foi realizado estudo retrospectivo de 5 anos em um hospital universitário. Foram avaliados 104 pacientes consecutivos com sepse, sendo 55,8% homens. A mortalidade foi de 68,3%, associada à idade elevada (p<0,05). Doenças crônicas associadas e sítio de infecção não relacionados ao prognóstico. Identificação de bactérias Gram-positivos foi mais frequente em sobreviventes (p<0,05) e não detecção do germe foi associada à mortalidade (p<0,01). O uso apropriado de antibióticos (germe sensível a pelo menos uma droga administrada) foi associado à sobrevida (p<0,0001) enquanto uso inapropriado (p<0,05) ou empírico (p<0,01) foi mais freqüente em não sobreviventes. No diagnóstico, leucocitose foi a principal (54,8%) alteração no leucograma. Na evolução, leucograma normal foi associado à sobrevida (p<0,01) e leucocitose à mortalidade (p<0,05). Em conclusão, a mortalidade foi associada à ausência de detecção do germe, leucocitose na evolução da sepse e uso inapropriado ou empírico de antibióticos. O tratamento baseado em evidências e direcionado para fatores de risco que podem ser modificados deve melhorar o prognóstico do paciente com sepse.Palavras-chaves: Sepse. Prognóstico. Antimicrobianos. Fatores de risco.Fatores de risco.

show abstract

“…Severe sepsis and septic shock carry a high mortality and account for a large proportion of patients admitted to intensive care units (54)(55)(56)(57). It is widely accepted that the release of large amounts of pro-and anti-inflammatory mediators that occurs in severe sepsis contributes to the development of multiple organ dysfunction syndrome (MODS) (8,(58)(59)(60), including ARF.…”

Section: Efficacy Of Crrt In Patients With Severe Sepsis or Septic Shockmentioning

confidence: 99%

Continuous Renal Replacement Therapies in Patients with Severe Sepsis and Septic Shock

García-Miguel¹

2012

Sepsis - An Ongoing and Significant Challenge

View full text Add to dashboard Cite

Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost

Cited by 148 publications

References 36 publications

Incidence and Outcome of Sepsis in Japanese Intensive Care Units: The Japanese Nosocomial Infection Surveillance System

Incidence and Outcome of Sepsis in Japanese Intensive Care Units: The Japanese Nosocomial Infection Surveillance System

Comparative study of survivor and nonsurvivor sepsis patients in a university hospital

Continuous Renal Replacement Therapies in Patients with Severe Sepsis and Septic Shock

Contact Info

Product

Resources

About