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Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study.
Intensive Care Med. 2016 Dec; 42(12):1980-1989.IC

Abstract

PURPOSE

To estimate the incidence density, point prevalence and outcome of severe sepsis and septic shock in German intensive care units (ICUs).

METHODS

In a prospective, multicentre, longitudinal observational study, all patients already on the ICU at 0:00 on 4 November 2013 and all patients admitted to a participating ICU between 0:00 on 4 November 2013 and 2359 hours on 1 December 2013 were included. The patients were followed up for the occurrence of severe sepsis or septic shock (SEPSIS-1 definitions) during their ICU stay.

RESULTS

A total of 11,883 patients from 133 ICUs at 95 German hospitals were included in the study, of whom 1503 (12.6 %) were diagnosed with severe sepsis or septic shock. In 860 cases (57.2 %) the infections were of nosocomial origin. The point prevalence was 17.9 % (95 % CI 16.3-19.7).The calculated incidence rate of severe sepsis or septic shock was 11.64 (95 % CI 10.51-12.86) per 1000 ICU days. ICU mortality in patients with severe sepsis/septic shock was 34.3 %, compared with 6 % in those without sepsis. Total hospital mortality of patients with severe sepsis or septic shock was 40.4 %. Classification of the septic shock patients using the new SEPSIS-3 definitions showed higher ICU and hospital mortality (44.3 and 50.9 %).

CONCLUSIONS

Severe sepsis and septic shock continue to be a frequent syndrome associated with high hospital mortality. Nosocomial infections play a major role in the development of sepsis. This study presents a pragmatic, affordable and feasible method for the surveillance of sepsis epidemiology. Implementation of the new SEPSIS-3 definitions may have a major effect on future epidemiological data.

Authors

No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

27686355

Citation

SepNet Critical Care Trials Group. "Incidence of Severe Sepsis and Septic Shock in German Intensive Care Units: the Prospective, Multicentre INSEP Study." Intensive Care Medicine, vol. 42, no. 12, 2016, pp. 1980-1989.
SepNet Critical Care Trials Group. Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study. Intensive Care Med. 2016;42(12):1980-1989.
SepNet Critical Care Trials Group. (2016). Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study. Intensive Care Medicine, 42(12), 1980-1989. https://doi.org/10.1007/s00134-016-4504-3
SepNet Critical Care Trials Group. Incidence of Severe Sepsis and Septic Shock in German Intensive Care Units: the Prospective, Multicentre INSEP Study. Intensive Care Med. 2016;42(12):1980-1989. PubMed PMID: 27686355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study. A1 - ,, Y1 - 2016/09/29/ PY - 2015/10/03/received PY - 2016/08/12/accepted PY - 2016/10/1/pubmed PY - 2017/9/19/medline PY - 2016/10/1/entrez KW - Incidence KW - Incidence density KW - Prevalence KW - Sepsis KW - Septic shock SP - 1980 EP - 1989 JF - Intensive care medicine JO - Intensive Care Med VL - 42 IS - 12 N2 - PURPOSE: To estimate the incidence density, point prevalence and outcome of severe sepsis and septic shock in German intensive care units (ICUs). METHODS: In a prospective, multicentre, longitudinal observational study, all patients already on the ICU at 0:00 on 4 November 2013 and all patients admitted to a participating ICU between 0:00 on 4 November 2013 and 2359 hours on 1 December 2013 were included. The patients were followed up for the occurrence of severe sepsis or septic shock (SEPSIS-1 definitions) during their ICU stay. RESULTS: A total of 11,883 patients from 133 ICUs at 95 German hospitals were included in the study, of whom 1503 (12.6 %) were diagnosed with severe sepsis or septic shock. In 860 cases (57.2 %) the infections were of nosocomial origin. The point prevalence was 17.9 % (95 % CI 16.3-19.7).The calculated incidence rate of severe sepsis or septic shock was 11.64 (95 % CI 10.51-12.86) per 1000 ICU days. ICU mortality in patients with severe sepsis/septic shock was 34.3 %, compared with 6 % in those without sepsis. Total hospital mortality of patients with severe sepsis or septic shock was 40.4 %. Classification of the septic shock patients using the new SEPSIS-3 definitions showed higher ICU and hospital mortality (44.3 and 50.9 %). CONCLUSIONS: Severe sepsis and septic shock continue to be a frequent syndrome associated with high hospital mortality. Nosocomial infections play a major role in the development of sepsis. This study presents a pragmatic, affordable and feasible method for the surveillance of sepsis epidemiology. Implementation of the new SEPSIS-3 definitions may have a major effect on future epidemiological data. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/27686355/Incidence_of_severe_sepsis_and_septic_shock_in_German_intensive_care_units:_the_prospective_multicentre_INSEP_study_ L2 - https://dx.doi.org/10.1007/s00134-016-4504-3 DB - PRIME DP - Unbound Medicine ER -