Intensive Care Medicine

, Volume 33, Issue 4, pp 606–618

Epidemiology of sepsis in Germany: results from a national prospective multicenter study

  • Christoph Engel
  • Frank M. Brunkhorst
  • Hans-Georg Bone
  • Reinhard Brunkhorst
  • Herwig Gerlach
  • Stefan Grond
  • Matthias Gruendling
  • Guenter Huhle
  • Ulrich Jaschinski
  • Stefan John
  • Konstantin Mayer
  • Michael Oppert
  • Derk Olthoff
  • Michael Quintel
  • Max Ragaller
  • Rolf Rossaint
  • Frank Stuber
  • Norbert Weiler
  • Tobias Welte
  • Holger Bogatsch
  • Christiane Hartog
  • Markus Loeffler
  • Konrad Reinhart
Original

Abstract

Objective

To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size.

Design

Prospective, observational, cross-sectional 1-day point-prevalence study.

Setting

454 ICUs from a representative nationwide sample of 310 hospitals stratified by size. Data were collected via 1-day on-site audits by trained external study physicians. Visits were randomly distributed over 1 year (2003).

Patients

Inflammatory response of all ICU patients was assessed using the ACCP/SCCM consensus conference criteria. Patients with severe sepsis were followed up after 3 months for hospital mortality and length of ICU stay.

Measurements and results

Main outcome measures were prevalence and mortality. A total of 3,877 patients were screened. Prevalence was 12.4% (95% CI, 10.9–13.8%) for sepsis and 11.0% (95% CI, 9.7–12.2%) for severe sepsis including septic shock. The ICU and hospital mortality of patients with severe sepsis was 48.4 and 55.2%, respectively, without significant differences between hospital size. Prevalence and mean length of ICU stay of patients with severe sepsis were significantly higher in larger hospitals and universities (≤ 200 beds: 6% and 11.5 days, universities: 19% and 19.2 days, respectively).

Conclusions

The expected number of newly diagnosed cases with severe sepsis in Germany amounts to 76–110 per 100,000 adult inhabitants. To allow better comparison between countries, future epidemiological studies should use standardized study methodologies with respect to sepsis definitions, hospital size, and daily and monthly variability.

Keywords

Sepsis Severe sepsis Epidemiology Prevalence Incidence Mortality 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Christoph Engel
    • 1
  • Frank M. Brunkhorst
    • 2
  • Hans-Georg Bone
    • 3
  • Reinhard Brunkhorst
    • 4
  • Herwig Gerlach
    • 5
  • Stefan Grond
    • 6
  • Matthias Gruendling
    • 7
  • Guenter Huhle
    • 8
  • Ulrich Jaschinski
    • 9
  • Stefan John
    • 10
  • Konstantin Mayer
    • 11
  • Michael Oppert
    • 12
  • Derk Olthoff
    • 13
  • Michael Quintel
    • 14
  • Max Ragaller
    • 15
  • Rolf Rossaint
    • 16
  • Frank Stuber
    • 17
  • Norbert Weiler
    • 18
  • Tobias Welte
    • 19
  • Holger Bogatsch
    • 1
  • Christiane Hartog
    • 2
  • Markus Loeffler
    • 1
  • Konrad Reinhart
    • 2
  1. 1.Institute of Medical Informatics, Statistics and EpidemiologyUniversity of LeipzigLeipzigGermany
  2. 2.Department of Anesthesiology and Intensive Care MedicineFriedrich-Schiller-University of JenaJenaGermany
  3. 3.Department of Anesthesiology and Intensive CareUniversity of MuensterMuensterGermany
  4. 4.Department of Internal MedicineKlinikum HannoverHannoverGermany
  5. 5.Department of Anesthesiology and Critical Care MedicineVivantes-Klinikum NeukoellnBerlinGermany
  6. 6.Department of AnesthesiaMartin-Luther-UniversityHalleGermany
  7. 7.Department of AnesthesiologyErnst-Moritz-Arndt-UniversityGreifswaldGermany
  8. 8.First Department of Medicine, Faculty of Clinical Medicine MannheimUniversity of HeidelbergMannheimGermany
  9. 9.Department of Anesthesiology and Critical Care MedicineKlinikum AugsburgAugsburgGermany
  10. 10.Department of Medicine IVUniversity of Erlangen-Nuernberg, Klinikum Nuernberg-SuedNuernbergGermany
  11. 11.Department of Internal MedicineJustus-Liebig-UniversityGiessenGermany
  12. 12.Department of Nephrology and Medical Intensive Care, CharitéCampus Virchow-Klinikum, University Medical CenterBerlinGermany
  13. 13.Department of Anesthesiology and Intensive Care MedicineUniversity Hospital LeipzigLeipzigGermany
  14. 14.Department of AnesthesiologyUniversity of GoettingenGoettingenGermany
  15. 15.Department of Anesthesiology and Intensive Care MedicineUniversity Hospital of the Technical University of DresdenDresdenGermany
  16. 16.Department of Anesthesiology, University Hospital AachenRheinisch-Westfaelische Technische Hochschule AachenAachenGermany
  17. 17.Department of Anesthesiology and Intensive Care MedicineRheinische Friedrich-Wilhelms-University BonnBonnGermany
  18. 18.Department of Anesthesiology and Intensive Care MedicineUniversity Hospital Schleswig-Holstein, Campus KielKielGermany
  19. 19.Department of Pneumology and Intensive CareUniversity of Hannover Medical SchoolHannoverGermany

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