Intensive Care Medicine

, Volume 33, Issue 3, pp 435–443

Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study

  • Sari Karlsson
  • Marjut Varpula
  • Esko Ruokonen
  • Ville Pettilä
  • Ilkka Parviainen
  • Tero I. Ala-Kokko
  • Elina Kolho
  • Esa M. Rintala
Original

DOI: 10.1007/s00134-006-0504-z

Cite this article as:
Karlsson, S., Varpula, M., Ruokonen, E. et al. Intensive Care Med (2007) 33: 435. doi:10.1007/s00134-006-0504-z

Abstract

Objective

To determine the incidence and outcome of severe sepsis in the adult Finnish population and to evaluate how treatment guidelines in severe sepsis are applied in clinical practice.

Study design

A prospective study in 24 closed multidisciplinary ICUs in 21 hospitals (4 university and 17 tertiary hospitals) in Finland.

Patients

All 4,500 consecutive ICU admission episodes were screened for severe sepsis during a 4-month period (1 November 2004 – 28 February 2005). The referral population was 3,743,225.

Results

The severe sepsis criteria were fulfilled in 470 patients, who had472 septic episodes. The incidence of severe sepsis in the ICUs in Finland was 0.38/1000 in the adult population (95% confidence interval 0.34–0.41). The mean ICU length of stay was 8.2 ± 8.1 days. ICU, hospital, and 1-year mortality rates were 15.5%, 28.3%, and 40.9%, respectively. Respiratory failure requiring ventilation support was the most common organ failure (86.2%); septic shock was present in 77% and acute renal failure in 20.6% of cases. Activated protein C was given to only 15 of the 55 patients with indication (27%) and low-dose corticosteroids to 150 of 366 (41%) patients with septic shock.

Conclusions

This prospective study found the incidence of ICU-treated severe sepsis in Finland to be 0.38 per 1,000 of the population. The ICU and hospital mortalities were also lower than earlier reported in United States or Australia. Evidence-based sepsis therapies were not used as often as recommended.

Keywords

Severe sepsisSeptic shockIncidenceMortalityTreatment protocols

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Sari Karlsson
    • 1
    • 2
  • Marjut Varpula
    • 3
  • Esko Ruokonen
    • 4
  • Ville Pettilä
    • 5
  • Ilkka Parviainen
    • 4
  • Tero I. Ala-Kokko
    • 6
  • Elina Kolho
    • 7
  • Esa M. Rintala
    • 8
  1. 1.Aurinkokatu 3B38HämeenlinnaFinland
  2. 2.Division of Intensive CareTampere University HospitalTampereFinland
  3. 3.Division of Intensive Care, Department of Internal MedicineHelsinki University HospitalHelsinkiFinland
  4. 4.Division of Intensive CareKuopio University HospitalKuopioFinland
  5. 5.Division of Intensive Care, Department of SurgeryHelsinki University HospitalHelsinkiFinland
  6. 6.Division of Intensive Care, Department of AnesthesiologyOulu University HospitalOuluFinland
  7. 7.Division of Infectious Diseases, Department of Internal MedicineHelsinki University HospitalHelsinkiFinland
  8. 8.Division of Infectious Diseases, Department of Internal MedicineSatakunta Central HospitalSatakuntaFinland