Epidemiology and Microbiology of Sepsis Syndromes in a University-Affiliated Urban Teaching Hospital and Level-1 Trauma and Burn Center

Abstract

Purpose:

To use the 2010 to 2011 data collected by structured chart review to provide a detailed up-to-date description of the epidemiology and microbiology of the sepsis syndromes.

Methods:

Prospective observational study conducted at a university-affiliated urban teaching hospital and level-1 trauma and burn center. All adult patients who triggered a Code Sepsis in the emergency department (ED) between January 2010 and December 2011 were included.

Results:

One hundred eighty four patients presented with a verified sepsis syndrome and triggered a Code Sepsis in the ED during the studied time period. The mean hospital and intensive care unit length of stays (LOSs) were 15.4 (interquartile range [IQR] = 14) and 6.7 (IQR = 5) days, respectively. The total inpatient mortality was 19% (n = 35). Patients with an unspecified source of infection and those without an isolated pathogen had the highest inpatient mortality, 42.1% (n = 8) and 23.3% (n = 10), respectively.

Conclusion:

Hospital mortality and hospital LOS of sepsis are similar to those reported in other observational studies. Our study confirms a decline in the mortality of sepsis predicted by earlier longitudinal studies and should prompt a resurgence of epidemiological research of the sepsis syndromes in the United States.

Keywords

sepsis syndrome septic shock epidemiology microbiology urban hospital

Get full access to this article

View all access options for this article.

References

Lagu

Rothberg

Shieh

Pekow

Steingrub

Lindenauer

. Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. Crit Care Med. 2012;40(3):754–761.

Angus

Linde-Zwirble

Lidicker

Clermont

Carcillo

Pinsky

. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated cost of cares. Crit Care Med. 2001;29(7):1303–1310.

Ani

Farshidpanah

Stewart

Nguyen

. Variations in organism-specific severe sepsis mortality in the United States: 1999-2008. Crit Care Med. 2015;43(1):65–77.

Kumar

Taneja

. Nationwide trends of severe sepsis in the 21st century (2000-2007). Chest. 2011;140(5):1223–1231.

Stevenson

Rubenstein

Radin

Soylemez Wiener

Walkey

. Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis. Crit Care Med. 2014;42(3):625–631.

Dreiher

Almog

Sprung

. Temporal trends in patient characteristics and survival of intensive care admissions with sepsis: a multicenter analysis. Crit Care Med. 2012;40(3):855–860.

Iwashyna

Odden

Rohde

. Identifying patients with severe sepsis using administrative claims: patient-level validation of the angus implementation of the international consensus conference definition of severe sepsis. Med Care. 2014;52(6):e39–e43.

Cremer

. Can administrative data be used to consistently measure the burden of sepsis? Crit Care Med. 2014;42(3):747–749.

Haut

Pronovost

Schneider

. Limitations of administrative databases. JAMA. 2012;307(24):2589–2590.

10.

Rhee

Murphy

Platt

Klompas

. Comparison of trends in sepsis incidence and coding using administrative claims versus objective clinical data. Clin Infect Dis. 2015;60(1):88–95.

11.

Whittaker

Mikkelsen

Gaieski

Koshy

Kean

Fuchs

. Severe sepsis cohorts derived from claims-based strategies appear to be biased toward a more severely ill patient population. Crit Care Med. 2013;41(4):945–953.

12.

Dellinger

Levy

Carlet

. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med. 2008;36(1):296–327.

13.

Levy

Fink

Marshall

. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Crit Care Med. 2003;31(4):1250–1256.

14.

Banta

Joshi

Beeson

Nguyen

. Patient and hospital characteristics associated with inpatient severe sepsis mortality in California, 2005-2010. Crit Care Med. 2012;40(11):2960–2966.

15.

Kaukonen

Bailey

Suzuki

Pilcher

Bellomo

. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014;311(13):1308–1316.

16.

Dombrovskiy

Martin

Sunderram

Paz

. Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med. 2007;35(5):1244–1250.

17.

Martin

Mannino

Eaton

Moss

. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546–1554.

18.

Gaieski

Mikkelsen

Band

. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010;38(4):1045–1053.

19.

Hitti

Lewin

III Lopez

. Improving door-to-antibiotic time in severely septic emergency department patients. J Emerg Med. 2012;42(4):462–469.