Incidence of severe sepsis and septic shock in German intensive care Units: the prospective, multicentre INSEP study
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Incidence of severe sepsis and septic shock in German intensive care Units: the prospective, multicentre INSEP study. / SepNet Critical Care Trials Group.
In: INTENS CARE MED, Vol. 42, No. 12, 12.2016, p. 1980-1989.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Incidence of severe sepsis and septic shock in German intensive care Units: the prospective, multicentre INSEP study
AU - Kluge, Stefan
AU - Nierhaus, Axel
AU - de Heer, Geraldine
AU - SepNet Critical Care Trials Group
PY - 2016/12
Y1 - 2016/12
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.
AB - 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.
KW - Aged
KW - Chi-Square Distribution
KW - Female
KW - Germany
KW - Hospital Mortality
KW - Humans
KW - Incidence
KW - Intensive Care Units
KW - Length of Stay
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Sepsis
KW - Shock, Septic
KW - Journal Article
KW - Multicenter Study
KW - Observational Study
U2 - 10.1007/s00134-016-4504-3
DO - 10.1007/s00134-016-4504-3
M3 - SCORING: Journal article
C2 - 27686355
VL - 42
SP - 1980
EP - 1989
JO - INTENS CARE MED
JF - INTENS CARE MED
SN - 0342-4642
IS - 12
ER -