TY - JOUR
T1 - Epidemiology of sepsis and septic shock in intensive care units between sepsis-2 and sepsis-3 populations
T2 - sepsis prognostication in intensive care unit and emergency room (SPICE-ICU)
AU - Abe, Toshikazu
AU - Yamakawa, Kazuma
AU - Ogura, Hiroshi
AU - Kushimoto, Shigeki
AU - Saitoh, Daizoh
AU - Fujishima, Seitaro
AU - Otomo, Yasuhiro
AU - Kotani, Joji
AU - Umemura, Yutaka
AU - Sakamoto, Yuichiro
AU - Sasaki, Junichi
AU - Shiino, Yasukazu
AU - Takeyama, Naoshi
AU - Tarui, Takehiko
AU - Shiraishi, Shin Ichiro
AU - Tsuruta, Ryosuke
AU - Nakada, Taka Aki
AU - Hifumi, Toru
AU - Hagiwara, Akiyoshi
AU - Ueyama, Masashi
AU - Yamashita, Norio
AU - Masuno, Tomohiko
AU - Ikeda, Hiroto
AU - Komori, Akira
AU - Iriyama, Hiroki
AU - Gando, Satoshi
N1 - Funding Information:
We thank the JAAM SPICE Study Group for the contribution to this study. We would like to thank Enago (https://www.enago.jp) for English language editing. This work was supported by JSPS KAKENHI Grant Number JP19K19376.
Funding Information:
This study was supported by the Japanese Association for Acute Medicine (2014-01).
Publisher Copyright:
© 2020 The Author(s).
PY - 2020/6/30
Y1 - 2020/6/30
N2 - Background: Diagnosing sepsis remains difficult because it is not a single disease but a syndrome with various pathogen- and host factor-associated symptoms. Sepsis-3 was established to improve risk stratification among patients with infection based on organ failures, but it has been still controversial compared with previous definitions. Therefore, we aimed to describe characteristics of patients who met sepsis-2 (severe sepsis) and sepsis-3 definitions. Methods: This was a multicenter, prospective cohort study conducted by 22 intensive care units (ICUs) in Japan. Adult patients (≥ 16 years) with newly suspected infection from December 2017 to May 2018 were included. Those without infection at final diagnosis were excluded. Patient's characteristics and outcomes were described according to whether they met each definition or not. Results: In total, 618 patients with suspected infection were admitted to 22 ICUs during the study, of whom 530 (85.8%) met the sepsis-2 definition and 569 (92.1%) met the sepsis-3 definition. The two groups comprised different individuals, and 501 (81.1%) patients met both definitions. In-hospital mortality of study population was 19.1%. In-hospital mortality among patients with sepsis-2 and sepsis-3 patients was comparable (21.7% and 19.8%, respectively). Patients exclusively identified with sepsis-2 or sepsis-3 had a lower mortality (17.2% vs. 4.4%, respectively). No patients died if they did not meet any definitions. Patients who met sepsis-3 shock definition had higher in-hospital mortality than those who met sepsis-2 shock definition. Conclusions: Most patients with infection admitted to ICU meet sepsis-2 and sepsis-3 criteria. However, in-hospital mortality did not occur if patients did not meet any criteria. Better criteria might be developed by better selection and combination of elements in both definitions.
AB - Background: Diagnosing sepsis remains difficult because it is not a single disease but a syndrome with various pathogen- and host factor-associated symptoms. Sepsis-3 was established to improve risk stratification among patients with infection based on organ failures, but it has been still controversial compared with previous definitions. Therefore, we aimed to describe characteristics of patients who met sepsis-2 (severe sepsis) and sepsis-3 definitions. Methods: This was a multicenter, prospective cohort study conducted by 22 intensive care units (ICUs) in Japan. Adult patients (≥ 16 years) with newly suspected infection from December 2017 to May 2018 were included. Those without infection at final diagnosis were excluded. Patient's characteristics and outcomes were described according to whether they met each definition or not. Results: In total, 618 patients with suspected infection were admitted to 22 ICUs during the study, of whom 530 (85.8%) met the sepsis-2 definition and 569 (92.1%) met the sepsis-3 definition. The two groups comprised different individuals, and 501 (81.1%) patients met both definitions. In-hospital mortality of study population was 19.1%. In-hospital mortality among patients with sepsis-2 and sepsis-3 patients was comparable (21.7% and 19.8%, respectively). Patients exclusively identified with sepsis-2 or sepsis-3 had a lower mortality (17.2% vs. 4.4%, respectively). No patients died if they did not meet any definitions. Patients who met sepsis-3 shock definition had higher in-hospital mortality than those who met sepsis-2 shock definition. Conclusions: Most patients with infection admitted to ICU meet sepsis-2 and sepsis-3 criteria. However, in-hospital mortality did not occur if patients did not meet any criteria. Better criteria might be developed by better selection and combination of elements in both definitions.
KW - In-hospital mortality
KW - Intensive care unit
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=85087969861&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087969861&partnerID=8YFLogxK
U2 - 10.1186/s40560-020-00465-0
DO - 10.1186/s40560-020-00465-0
M3 - Article
AN - SCOPUS:85087969861
SN - 2052-0492
VL - 8
JO - Journal of Intensive Care
JF - Journal of Intensive Care
IS - 1
M1 - 44
ER -