Sepsis and septic shock in France: incidences, outcomes and costs of care.
Epidemiology
Secular trends
Sepsis
Septic shock
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
20 Oct 2020
20 Oct 2020
Historique:
received:
24
04
2020
accepted:
08
10
2020
entrez:
20
10
2020
pubmed:
21
10
2020
medline:
21
10
2020
Statut:
epublish
Résumé
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. 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. 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). 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 33079281
doi: 10.1186/s13613-020-00760-x
pii: 10.1186/s13613-020-00760-x
pmc: PMC7575668
doi:
Types de publication
Journal Article
Langues
eng
Pagination
145Références
Crit Care Med. 2007 May;35(5):1244-50
pubmed: 17414736
Clin Infect Dis. 2015 Jan 1;60(1):88-95
pubmed: 25258352
Crit Care Med. 2001 Jul;29(7):1303-10
pubmed: 11445675
BMC Infect Dis. 2014 Dec 21;14:3863
pubmed: 25528662
J Crit Care. 2017 Jun;39:48-55
pubmed: 28199891
JAMA. 2017 Oct 3;318(13):1241-1249
pubmed: 28903154
JAMA. 2008 May 21;299(19):2294-303
pubmed: 18492971
Crit Care. 2015 Apr 06;19:139
pubmed: 25887596
J Infect. 2017 Nov;75(5):409-419
pubmed: 28851532
Crit Care Med. 2019 Apr;47(4):493-500
pubmed: 30431493
Crit Care Med. 2013 May;41(5):1167-74
pubmed: 23442987
J Crit Care. 2016 Feb;31(1):58-62
pubmed: 26601855
Intensive Care Med. 2018 Nov;44(11):1826-1835
pubmed: 30284637
Crit Care Med. 2013 Feb;41(2):580-637
pubmed: 23353941
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
Am J Respir Crit Care Med. 2019 Oct 15;200(8):972-981
pubmed: 31161771
Crit Care Med. 2012 Mar;40(3):754-61
pubmed: 21963582
Clin Infect Dis. 2016 Mar 15;62(6):695-703
pubmed: 26787173
N Engl J Med. 2003 Apr 17;348(16):1546-54
pubmed: 12700374
Ann Intensive Care. 2017 Dec;7(1):19
pubmed: 28220453
Chest. 2011 Nov;140(5):1223-1231
pubmed: 21852297
Lancet Respir Med. 2014 May;2(5):380-6
pubmed: 24740011
Intensive Care Med. 2008 Jan;34(1):17-60
pubmed: 18058085
Am J Respir Crit Care Med. 2016 Feb 1;193(3):228-30
pubmed: 26829417
Crit Care Med. 2016 Dec;44(12):2223-2230
pubmed: 27352126
JAMA. 1998 Nov 18;280(19):1690-1
pubmed: 9832001
Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72
pubmed: 26414292
Chest. 2017 Feb;151(2):278-285
pubmed: 27452768