Sepsis and septic shock in France: incidences, outcomes and costs of care

Abstract

Background Sepsis is one of the leading causes of death worldwide. The associated incidence, mortality and trends do not differ greatly between documented reports. The purpose of this study was to provide an in-depth description of patients with sepsis and septic shock hospitalized in France from 2010 to 2015 and to explore the temporal trends of their clinical characteristics, costs and outcomes. Methods Retrospective cohort study of the French hospital administrative database in which organ failure therapies and severity scores are systematically registered. All patients admitted between 2010 and 2015 for sepsis and septic shock as defined by an ICD-10 code for infection, and for organ failure or the use of organ failure supplementation were included. Incidence, outcomes and trends were analyzed. Subgroup analyses based on several coding strategies and adjusted for severity scores were performed. Results A total of 737,147 patients with sepsis and 492,902 patients with septic shock were included. From 2010 to 2015, the incidence of sepsis and septic shock increased, respectively, from 206 to 243 and from 135 to 171 cases per 100,000 population. Case fatality remained at 34% for sepsis, but decreased from 46 to 44% for septic shock. Median hospital stay costs amounted to €11,400 (IQR: 5036; 24,364) for patients with sepsis and €16,439 (IQR: 7339; 29,360) for patients with septic shock. After adjustment for case-mix and illness severity, the risk of death was stable for sepsis (0.08% [− 0.04; 0.20] per year), but decreased for sepsis patients admitted to the intensive care unit and for cases of septic shock (− 0.33%[ − 0.40; − 0.27] per year). Conclusions Sepsis is common, frequently fatal and expensive to treat. Its incidence has increased. Case fatality has decreased in most severely affected patients, owing partly to general improvements in care.

Survival after COVID-19-associated organ failure among inpatients with systemic lupus erythematosus in France: a nationwide study

“…We defined COVID-19-AOF as the combination of at least one of the diagnosis codes of COVID-19 (ICD-10 codes ‘U071’, ‘U0710’, ‘U0711’, ‘U0712’, ‘U0714’, ‘U0715’), with one code referring to an organ failure diagnosis (listed in online supplemental materials). This definition, which matches the definition for sepsis, has been previously used and validated in medical administrative database studies 12–14. To be allocated in the SLE group, COVID-19-AOF had to follow or be concomitant with an SLE ‘M32’ code.…”

Early combination of albumin with crystalloids administration might be beneficial for the survival of septic patients: a retrospective analysis from MIMIC-IV database

“…Recently study reports that sepsis, in the USA, affects over 1.7 million patients and accounts for more than 50% of mortality in hospitals annually [3]. Due to the published guidelines for sepsis, the advance of machines, and antibiotic therapy, the mortality of sepsis has been decreased in these years, but still stayed at a high level [4][5][6][7][8].…”

Energetic dysfunction in sepsis: a narrative review

“…Sepsis is a well-recognized, worldwide healthcare issue defined as life-threatening organ dysfunction resulting from a dysregulated host response to an infection [1][2][3][4][5]. This response is generally characterized by an acute and massive release of stress hormones, leading to an overwhelming production of energy substrates in the form of glucose, fatty acids (FA), amino acids and lactate.…”