Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland

Padkin, Andrew; Goldfrad, Caroline; Brady, Tony; Young, John; Black, Nick; Rowan, Kathy

doi:10.1097/01.ccm.0000085141.75513.2b

Cited by 403 publications

(291 citation statements)

References 24 publications

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“…The results of our study are important for the following reasons: The prevalence of septic patients treated in the ICU was similar to that reported in other studies (16)(17)(18)(19), as well as the overall mortality. However, it was greater than that observed in some treatment arms of clinical studies (12).…”

Section: Discussionsupporting

confidence: 76%

“…Several reports have confirmed that severe sepsis is found in 2% of patients admitted to the general ward, while it is found in up to 75% of ICU patients (18,20,26,27). It is logical to consider that severely ill, infected patients should be admitted to the ICU, and this can partly explain the high frequency of sepsis in the Table 4.…”

Section: Discussionmentioning

confidence: 97%

“…Recent studies from Europe, the United Kingdom, Australia, and New Zealand have shown the incidence rates of sepsis and its mortality in the ICU (16)(17)(18)(19)(20). North American studies are limited to data obtained in four Canadian intensive care units that participated in a multinational study (Alberti), or taken from administrative databases (1).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Ortíz¹,

Dueñas²,

Rodríguez

et al. 2013

biomedica

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Ortíz¹,

Dueñas²,

Rodríguez

et al. 2013

biomedica

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“…Severe sepsis was defined according to a modified version of the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) clinical trial definition. 117 Septic shock was defined as severe sepsis with cardiovascular organ system dysfunction. 118 Readmissions of women to critical care during the same hospital stay were excluded.…”

Section: Intensive Care National Audit and Research Centrementioning

confidence: 99%

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Knight

Acosta

Brocklehurst

et al. 2016

Programme Grants Appl Res

101

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BackgroundStudies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision.ObjectivesTo (1) estimate the incidence of specific near-miss morbidities; (2) assess the contribution of existing risk factors to incidence; (3) describe different interventions and their impact on outcomes and costs; (4) identify any groups in which outcomes differ; (5) investigate factors associated with maternal death; (6) compare an external confidential enquiry or a local review approach for investigating quality of care for affected women; and (7) assess the longer-term impacts.MethodsMixed quantitative and qualitative methods including primary national observational studies, database analyses, surveys and case studies overseen by a user advisory group.SettingMaternity units in all four countries of the UK.ParticipantsWomen with near-miss maternal morbidities, their partners and comparison women without severe morbidity.Main outcome measuresThe incidence, risk factors, management and outcomes of uterine rupture, placenta accreta, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, severe sepsis, amniotic fluid embolism and pregnancy at advanced maternal age (≥ 48 years at completion of pregnancy); factors associated with progression from severe morbidity to death; associations between severe maternal morbidity and ethnicity and socioeconomic status; lessons for care identified by local and external review; economic evaluation of interventions for management of postpartum haemorrhage (PPH); women’s experiences of near-miss maternal morbidity; long-term outcomes; and models of maternity care commissioned through experience-led and standard approaches.ResultsWomen and their partners reported long-term impacts of near-miss maternal morbidities on their physical and mental health. Older maternal age and caesarean delivery are associated with severe maternal morbidity in both current and future pregnancies. Antibiotic prescription for pregnant or postpartum women with suspected infection does not necessarily prevent progression to severe sepsis, which may be rapidly progressive. Delay in delivery, of up to 48 hours, may be safely undertaken in women with HELLP syndrome in whom there is no fetal compromise. Uterine compression sutures are a cost-effective second-line therapy for PPH. Medical comorbidities are associated with a fivefold increase in the odds of maternal death from direct pregnancy complications. External reviews identified more specific clinical messages for care than local reviews. Experience-led commissioning may be used as a way to commission maternity services.LimitationsThis programme used observational studies, some with limited sample size, and the possibility of uncontrolled confounding cannot be excluded.ConclusionsImplementation of the findings of this research could prevent both future severe pregnancy complications as well as improving the outcome of pregnancy for women. One of the clearest findings relates to the population of women with other medical and mental health problems in pregnancy and their risk of severe morbidity. Further research into models of pre-pregnancy, pregnancy and postnatal care is clearly needed.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…[1][2][3][4][5] It is the 10 th most common cause of death in the United States and its management has been estimated to cost 17 billion dollars annually. 5 Among the many co-morbidities associated with increased risk for sepsis, malignancy carries one of the highest associated risks for developing sepsis and sepsis-related mortality.…”

Section: Introductionmentioning

confidence: 99%

Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies

Mato¹,

Fuchs²,

Heitjan³

et al. 2009

Cancer Biology & Therapy

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Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland

Abstract: Severe sepsis is common and presents a major challenge for clinicians, managers, and healthcare policymakers. Intensive care unit admissions meeting severe sepsis criteria have a high mortality rate and high resource use.

Cited by 403 publications

References 24 publications

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Beyond maternal death: improving the quality of maternal care through national studies of ‘near-miss’ maternal morbidity

Utility of the systemic inflammatory response syndrome (SIRS) criteria in predicting the onset of septic shock in hospitalized patients with hematologic malignancies

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