Predictive and prognostic factors of septic shock of nosocomial origin

Quenot, JP; Pavon, Arnaud; Binquet, Christine; Kara, F; Martinet, Olivier; Ganster, Frédérique; Navellou, JC; Castelain, Vincent; Barraud, Damien; Cousson, J.; Poussel, J.F.; Perez, Pierre; Kuteifan, Khaldoun; Noirot, A

doi:10.1186/cc10656

Cited by 1 publication

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“…Thirty-two of 38 hospital-wide and ICU-based studies were multicentre trials, including one large international study [ 72 ] with data from 730 ICUs from 84 countries worldwide. Thirty-three of 38 hospital-wide and ICU-based studies relied on consensus sepsis definitions (22 × sepsis-1 [ 15 ], 3 × sepsis-2 [ 16 ], 2 × sepsis-3 [ 1 ], 4 × sepsis-1/-2 consensus definitions, and two used the 2005 definition of International Pediatric Sepsis Definition Consensus Conference [ 73 ]); of the remaining five, one study used a modified definition [ 50 ] and four hospital-wide studies used ICD-9-based case definitions(Supplementary material 2, Table 1). All ICU-based studies used clinical sepsis definitions.…”

Section: Resultsmentioning

confidence: 99%

“…A pooled analysis of fourteen studies [ 32 – 35 , 38 , 41 , 44 – 46 , 48 , 52 , 54 , 57 ] showed that 48.7% (95% 38.3–59.3%, range 18.7–69.4%) of all cases of sepsis with organ dysfunction treated in ICUs were hospital-acquired. For septic shock, two incidence studies [ 38 , 50 ] showed that 35.7 and 37.4% of all septic shock cases treated in ICUs had a hospital origin (pooled estimate: 35.8% [95% CI 33.2–38.5%]). Pooled estimates were not different between studies with moderate and low risk of bias (Supplementary material 2, Table 7).…”

Section: Resultsmentioning

confidence: 99%

“…Compared to the adult studies, Shime and colleagues showed lower mortality rates for ICU-acquired and HA sepsis with organ dysfunction in paediatric ICU patients (21.3% and 30.1%, respectively). The study by Quenot and colleagues [50] reported a mortality rate of 53.6% among ICU patients with HA septic shock. No study provided data on the mortality of neonates in NICUs with HA neonatal sepsis, but two studies [59,68] reported a mortality of 10.0% and 38.0% for blood culture-proven neonatal sepsis, respectively (pooled estimate: 21.9% [95% CI 5.0-59.7%]) (Supplementary material 2, Table 5).…”

Section: Mortalitymentioning

confidence: 97%

“…Only two studies were from the WHO Eastern Mediterranean region [33,38], and only one from the South-East Asia region [23]; no eligible study was identified from the WHO Africa region. Thirty-two of 38 hospital-wide and ICU-based studies were multicentre trials, including one large international study [72] [73]); of the remaining five, one study used a modified definition [50] and four hospital-wide studies used ICD-9-based case definitions(Supplementary material 2, Table 1). All ICUbased studies used clinical sepsis definitions.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…A pooled analysis of fourteen studies [32-35, 38, 41, 44-46, 48, 52, 54, 57] showed that 48.7% (95% 38.3-59.3%, range 18.7-69.4%) of all cases of sepsis with organ dysfunction treated in ICUs were hospitalacquired. For septic shock, two incidence studies [38,50] Table 7).…”

Section: Ha Sepsis Among All Sepsis Cases Hospital-wide and In Icusmentioning

confidence: 99%

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Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis

et al. 2020

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Purpose: Sepsis is recognized as a global public health problem, but the proportion due to hospital-acquired infections remains unclear. We aimed to summarize the epidemiological evidence related to the burden of hospitalacquired (HA) and ICU-acquired (ICU-A) sepsis. Methods: We searched MEDLINE, Embase and the Global Index Medicus from 01/2000 to 03/2018. We included studies conducted hospital-wide or in intensive care units (ICUs), including neonatal units (NICUs), with data on the incidence/prevalence of HA and ICU-A sepsis and the proportion of community and hospital/ICU origin. We did random-effects meta-analyses to obtain pooled estimates; inter-study heterogeneity and risk of bias were assessed. Results: Of the 13,239 studies identified, 51 met the inclusion criteria; 22 were from low-and middle-income countries. Twenty-eight studies were conducted in ICUs, 13 in NICUs, and ten hospital-wide. The proportion of HA sepsis among all hospital-treated sepsis cases was 23.6% (95% CI 17-31.8%, range 16-36.4%). In the ICU, 24.4% (95% CI 16.7-34.2%, range 10.3-42.5%) of cases of sepsis with organ dysfunction were acquired during ICU stay and 48.7% (95% CI 38.3-59.3%, range 18.7-69.4%) had a hospital origin. The pooled hospital incidence of HA sepsis with organ dysfunction per 1000 patients was 9.3 (95% CI 7.3-11.9, range 2-20.6)). In the ICU, the pooled incidence of HA sepsis with organ dysfunction per 1000 patients was 56.5 (95% CI 35-90.2, range 9.2-254.4) and it was particularly high in NICUs. Mortality of ICU patients with HA sepsis with organ dysfunction was 52.3% (95% CI 43.4-61.1%, range 30.1-64.6%). There was a significant inter-study heterogeneity. Risk of bias was low to moderate in ICU-based studies and moderate to high in hospital-wide and NICU studies.

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