Intensive Care Medicine

, Volume 42, Issue 12, pp 1980–1989 | Cite as

Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study

  • SepNet Critical Care Trials Group



To estimate the incidence density, point prevalence and outcome of severe sepsis and septic shock in German intensive care units (ICUs).


In a prospective, multicentre, longitudinal observational study, all patients already on the ICU at 0:00 on 4 November 2013 and all patients admitted to a participating ICU between 0:00 on 4 November 2013 and 2359 hours on 1 December 2013 were included. The patients were followed up for the occurrence of severe sepsis or septic shock (SEPSIS-1 definitions) during their ICU stay.


A total of 11,883 patients from 133 ICUs at 95 German hospitals were included in the study, of whom 1503 (12.6 %) were diagnosed with severe sepsis or septic shock. In 860 cases (57.2 %) the infections were of nosocomial origin. The point prevalence was 17.9 % (95 % CI 16.3–19.7).The calculated incidence rate of severe sepsis or septic shock was 11.64 (95 % CI 10.51–12.86) per 1000 ICU days. ICU mortality in patients with severe sepsis/septic shock was 34.3 %, compared with 6 % in those without sepsis. Total hospital mortality of patients with severe sepsis or septic shock was 40.4 %. Classification of the septic shock patients using the new SEPSIS-3 definitions showed higher ICU and hospital mortality (44.3 and 50.9 %).


Severe sepsis and septic shock continue to be a frequent syndrome associated with high hospital mortality. Nosocomial infections play a major role in the development of sepsis. This study presents a pragmatic, affordable and feasible method for the surveillance of sepsis epidemiology. Implementation of the new SEPSIS-3 definitions may have a major effect on future epidemiological data.


Sepsis Septic shock Incidence Incidence density Prevalence 



Writing Committee: Gernot Marx, Melanie Schäfer, Josef Briegel, Tobias Schuerholz, Stefan Schröder, Friedhelm Bach, Ulrich Jaschinski, Manfred Weiß, Stefan Kluge, Holger Bogatsch, Frank Bloos, Norbert Weiler, and Michael Oppert.

Study design and protocol: Gernot Marx, Frank Bloos, Josef Briegel, Herwig Gerlach, Matthias Gründling, Axel Nierhaus, Michael Oppert, Konrad Reinhart, Rolf Rossaint, Michael Quintel, Norbert Weiler, Manfred Weiß, and Christoph Engel.

Statistical Analysis: Holger Bogatsch performed the full statistical analysis.

Database: Matthias Loebe.

Supplementary material

134_2016_4504_MOESM1_ESM.tif (179 kb)
Supplementary material 1 (TIFF 178 kb)
134_2016_4504_MOESM2_ESM.xlsx (26 kb)
Supplementary material 2 (XLSX 25 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2016

Authors and Affiliations

  1. 1.Department of Intensive Care MedicineUniversity Hospital RWTH AachenAachenGermany

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