Skip to main content

Advertisement

Log in

Trends in hospitalizations of patients with sepsis and factors associated with inpatient mortality in the Region of Madrid, 2003–2011

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The objectives of this investigation were to study the temporal trends in hospitalizations of patients with sepsis in the Region of Madrid (Spain) from 2003 to 2011 and analyze the factors associated with inpatient mortality. All sepsis hospitalizations from the minimum basic data set (MBDS) during 2003 to 2011 in the Region of Madrid were analyzed. Gender-specific crude and age-adjusted rates were calculated each year. Factors associated with death in these patients were studied with bivariate and multivariate analyses. Simultaneously, sepsis inpatients also underwent descriptive analysis. The study included 98,898 sepsis episodes. The incidence of sepsis hospitalizations per 100,000 habitants increased in males from 114.4 in 2003 to 262.2 in 2011, and in females from 91.2 to 209.1 between 2003 and 2011. The observed inpatient mortality was 23.2 %. There were 45,936 (46.4 %) episodes of severe sepsis (≥1 organ failure), revealing a clear upward trend, especially in multi-organ failure. Severe sepsis mortality showed a decreasing trend in both males (40.0 to 31.8 % from 2003 through 2011) and females (41.6 to 35.2 % from 2003 through 2011). Death was most frequent among the elderly and in patients with more organ failures and comorbidities. In a populous region of Southern Europe, an upward trend in sepsis incidence was observed between 2003 and 2011, as well as a decreasing trend in mortality for sepsis inpatients. Mortality increased with age, comorbidities, and organ failures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D et al (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 31:1250–1256

    Article  PubMed  Google Scholar 

  2. Robertson CM, Coopersmith CM (2006) The systemic inflammatory response syndrome. Microbes Infect 8:1382–1389. doi:10.1016/j.micinf.2005.12.016

    Article  CAS  PubMed  Google Scholar 

  3. Slade E, Tamber PS, Vincent J-L (2003) The Surviving Sepsis Campaign: Raising awareness to reduce mortality. Crit Care 7:1–2

    Article  PubMed  Google Scholar 

  4. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310. http://www.ncbi.nlm.nih.gov/pubmed/11445675

    Article  CAS  PubMed  Google Scholar 

  5. Moss M (2005) Epidemiology of sepsis: race, sex, and chronic alcohol abuse. Clin Infect Dis 41(Suppl 7):S490–S497. doi:10.1086/432003,

    Article  PubMed  Google Scholar 

  6. Dombrovskiy VY, Martin AA, Sunderram J, Paz HL (2007) Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med 35:1244–1250. doi:10.1097/01.CCM.0000261890.41311.E9, http://www.ncbi.nlm.nih.gov/pubmed/17414736

    Article  PubMed  Google Scholar 

  7. Martin GS, Mannino DM, Eaton S, Moss M (2003) The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 348:1546–1554. doi:10.1056/NEJMoa022139, http://www.ncbi.nlm.nih.gov/pubmed/12700374

    Article  PubMed  Google Scholar 

  8. Kung H-C, Hoyert DL, Xu J, Murphy SL (2008) Deaths: final data for 2005. Natl Vital Stat Rep 56:1–120

    PubMed  Google Scholar 

  9. Blanco J, Muriel-Bombín A, Sagredo V, Taboada F, Gandía F, Tamayo L et al (2008) Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Crit Care 12:R158. doi:10.1186/cc7157, http://www.ncbi.nlm.nih.gov/pubmed/19091069

    Article  PubMed  Google Scholar 

  10. Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, Bion J et al (2010) The surviving sepsis campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Med 36:222–231. doi:10.1007/s00134-009-1738-3

    Article  PubMed Central  PubMed  Google Scholar 

  11. Andreu Ballester JC, Ballester F, González Sánchez A, Almela Quilis A, Colomer Rubio E, Peñarroja Otero C (2008) Epidemiology of sepsis in the Valencian community (Spain), 1995–2004. Infect Control Hosp 29:630–634. doi:10.1086/589583

    Article  Google Scholar 

  12. Iñigo J, Sendra JM, Díaz R, Bouza C, Sarría-Santamera A (2006) Epidemiología y costes de la sepsis grave en Madrid. Estudio de altas hospitalarias. Med Intensiva 30:197–203, http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0210-56912006000500001&nrm=iso

    Article  PubMed  Google Scholar 

  13. Azkárate I, Sebastián R, Cabarcos E, Choperena G, Pascal M, Salas E (2012) A prospective, observational severe sepsis/septic shock registry in a tertiary hospital in the province of Guipuzcoa (Spain). Med Intensiva 36:250–256. doi:10.1016/j.medin.2011.10.006

    Article  Google Scholar 

  14. Wenzel RP (2002) Treating sepsis. N Engl J Med 347:966–967. doi:10.1056/NEJMp020096, http://www.ncbi.nlm.nih.gov/pubmed/12324551

    Article  PubMed  Google Scholar 

  15. Banta JE, Joshi KP, Beeson L, Nguyen HB (2012) Patient and hospital characteristics associated with inpatient severe sepsis mortality in California, 2005–2010. Crit Care Med 40:2960–2966. doi: 10.1097/CCM.0b013e31825bc92f

    Article  PubMed  Google Scholar 

  16. Vincent J-L, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H et al (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353

    Article  PubMed  Google Scholar 

  17. Winters BD, Eberlein M, Leung J, Needham DM, Pronovost PJ, Sevransky JE (2010) Long-term mortality and quality of life in sepsis: a systematic review. Crit Care Med 38:1276–1283. doi:10.1097/CCM.0b013e3181d8cc1d

    PubMed  Google Scholar 

  18. Yende S, Angus DC (2007) Long-term outcomes from sepsis. Curr Infect Dis Rep 9:382–386

    Article  PubMed  Google Scholar 

  19. Iwashyna TJ, Ely EW, Smith DM, Langa KM (2010) Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 304:1787–1794. doi:10.1001/jama.2010.1553

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Sands KE, Bates DW, Lanken PN, Graman PS, Hibberd PL, Kahn KL et al (1997) Epidemiology of sepsis syndrome in 8 academic medical centers. JAMA 278:234–240

    Article  CAS  PubMed  Google Scholar 

  21. Harrison DA, Welch CA, Eddleston JM (2006) The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care 10:R42. doi:10.1186/cc4854

    Article  PubMed  Google Scholar 

  22. Vincent J-L, Opal S, Torres A, Bonten M, Cohen J, Wunderink R (2003) The PIRO concept: I is for infection. Crit Care 7:252–255. doi:10.1186/cc2194

    Article  PubMed  Google Scholar 

  23. Bates DW, Yu DT, Black E, Sands KE, Schwartz JS, Hibberd PL et al (2003) Resource utilization among patients with sepsis syndrome. Infect Control Hosp Epidemiol 24:62–70. doi:10.1086/502117

    Article  Google Scholar 

  24. Davies A, Green C, Hutton J, Chinn C (2001) Severe sepsis: a European estimate of the burden of disease in ICU. Intensive Care Med 27:581A

    Google Scholar 

  25. Burchardi H, Schneider H (2004) Economic aspects of severe sepsis: a review of intensive care unit costs, cost of illness and cost effectiveness of therapy. Pharmacoeconomics 22:793–813, http://www.ncbi.nlm.nih.gov/pubmed/15294012

    Article  PubMed  Google Scholar 

  26. Angus DC (2010) The lingering consequences of sepsis: a hidden public health disaster? JAMA 304:1833–1834. doi:10.1001/jama.2010.1546

    Article  CAS  PubMed  Google Scholar 

  27. Dombrovskiy VY, Martin AA, Sunderram J, Paz HL (2005) Facing the challenge: decreasing case fatality rates in severe sepsis despite increasing hospitalizations. Crit Care Med 33:2555–2562

    Article  PubMed  Google Scholar 

  28. Dombrovskiy VY, Martin AA, Sunderram J, Paz HL (2007) Occurrence and outcomes of sepsis: influence of race. Crit Care Med 35:763–768. doi:10.1097/01.CCM.0000256726.80998.BF

    Article  PubMed  Google Scholar 

  29. Kumar G, Kumar N, Taneja A, Kaleekal T, Tarima S, McGinley E et al (2011) Nationwide trends of severe sepsis in the 21st century (2000–2007). Chest 140:1223–1231. doi:10.1378/chest.11-0352

    Article  PubMed  Google Scholar 

  30. Wenzel RP, Edmond MB (2000) Managing antibiotic resistance. N Engl J Med 343:1961–1963. doi:10.1056/NEJM200012283432610

    Article  CAS  PubMed  Google Scholar 

  31. Melamed A, Sorvillo FJ (2009) The burden of sepsis-associated mortality in the United States from 1999 to 2005: an analysis of multiple-cause-of-death data. Crit Care 13:R28. doi:10.1186/cc7733

    Article  PubMed  Google Scholar 

  32. Ghelani D, Moran JL, Sloggett A, Leeson RJ, Peake SL (2009) Long-term survival of intensive care and hospital patient cohorts compared with the general Australian population: a relative survival approach. J Eval Clin Pract 15:425–435. doi:10.1111/j.1365-2753.2008.01030.x

    Article  PubMed  Google Scholar 

  33. Brun-Buisson C, Meshaka P, Pinton P, Vallet B (2004) EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 30:580–588. doi:10.1007/s00134-003-2121-4

    Article  CAS  PubMed  Google Scholar 

  34. Iwashyna TJ, Odden A, Rohde J, Bonham C, Kuhn L, Malani P et al (2012) 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. doi:10.1097/MLR.0b013e318268ac86

Download references

Acknowledgments

We thank Alexander J. Louie BSPH, BSN, RN-PHN of the University of California, Irvine, for the assistance with the revision of the manuscript.

Conflict of interest

All the authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to O. H. Ayala-Ramírez.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 46 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ayala-Ramírez, O.H., Domínguez-Berjón, M.F. & Esteban-Vasallo, M.D. Trends in hospitalizations of patients with sepsis and factors associated with inpatient mortality in the Region of Madrid, 2003–2011. Eur J Clin Microbiol Infect Dis 33, 411–421 (2014). https://doi.org/10.1007/s10096-013-1971-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-013-1971-0

Keywords

Navigation