Abstract
In recent years, several epidemiological studies have helped expand our knowledge of the incidence of sepsis at the intensive care unit (ICU) and population levels. However, more data are needed from developing countries. Overall, even with a lack of standardized definitions—particularly of sepsis-associated organ dysfunction, hypoperfusion or hypotension, and septic-induced cardiovascular failure despite adequate fluid resuscitation—the incidence of sepsis seems higher in Brazil, the United Kingdom, and Portugal. In the future, in order to better identify patients that need early ICU admission, aggressive care, and new therapies, we must develop and apply better instruments for definition and risk stratification, especially for evaluating the risk of progressing from sepsis to severe sepsis and septic shock.
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References and Recommended Reading
Bone RC, Balk RA, Cerra FB, et al.: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992, 101:1644–1655.
Matzinger P: The danger model: A renewed sense of self. Science 2002, 296:301–305.
Rangel-Frausto MS, Pittet D, Costigan M, et al.: The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA 1995, 273:117–123.
Brun-Buisson C, Doyon F, Carlet J: Bacteremia and severe sepsis in adults: a multicenter prospective survey in ICUs and wards of 24 hospitals. French Bacteremia-Sepsis Study Group. Am J Respir Crit Care Med 1996, 154:617–624.
Brun-Buisson C: The epidemiology of the systemic inflammatory response. Intensive Care Med 2000, 26:S64-S74.
Vincent JL, Bihari DJ, Suter PM, et al.: The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study. JAMA 1995, 1:639–644.
Levy MM, Fink MP, Marshall JC, et al.: 2001 SCCM/ ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med 2003, 29:530–538.
Linde-Zwirble WT, Angus D: Severe sepsis epidemiology: sampling, selection, and society. Crit Care 2004, 8:222–226. Very interesting discussion of the epidemiological problems of evaluating the incidence of sepsis in the hospital and ICU.
Marshall J, Vincent JL, Fink MP, et al.: Measures, markers, and mediators: Toward a staging system for clinical sepsis. Crit Care Med 2003, 31:1560–1567.
Vincent JL, Wendon J, Groeneveld J, et al.: The PIRO Concept: O is for organ dysfunction. Crit Care 2003, 7:260–264.
Angus DC, Burgner D, Wunderink R, et al.: The PIRO Concept: P is for predisposition. Crit Care 2003, 7:248–251.
Gerlach H, Dhainaut JF, Harbarth S, et al.: The PIRO Concept: R is for response. Crit Care 2003, 7:256–259.
Vincent JL, Opal S, Torres A, et al.: The PIRO Concept: I is for infection. Crit Care 2003, 7:252–255.
Bernard GR, Vincent JL, Laterre PF, et al.: Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001, 344:699–709.
Vincent JL, Moreno R, Takala J, et al.: The SOFA (Sepsisrelated organ failure assessment) score to describe organ dysfunction/failure. Intensive Care Med 1996, 22:707–710.
Marshall JC, Sibbald WJ, Cook DA, et al.: The multiple organ dysfunction (MOD) score: a reliable descriptor of a complex clinical outcome. Crit Care Med 1992, 20:S80.
Le Gall JR, Klar J, Lemeshow S, et al.: The logistic organ dysfunction system. A new way to assess organ dysfunction in the intensive care unit. JAMA 1996, 276:802–810.
Angus DC, Linde-Zwirble WT, Lidicker J, et al.: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associated costs of care. Crit Care Med 2001, 29:1303–1310.
Wenzel RP: Treating sepsis. N Engl J Med 2002, 348:966–967.
Salvo I, de Cian W, Musicco M, et al.: The Italian SEPSIS study: preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock. Intensive Care Med 1995, 21:S244-S249.
Brun-Buisson C, Doyon F, Carlet J, et al.: Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 1995, 274:968–974.
Sands KE, Bates DW, Lanken PN, et al.: Epidemiology of sepsis syndrome in 8 academic medical centers. Academic Medical Center Consortium Sepsis Project Working Group. JAMA 1997, 278:234–240.
Zahorec R, Firment J, Strakova J, et al.: Epidemiology of severe sepsis in intensive care units in the Slovak Republic. Infection 2005, 33:122–128.
Finfer S, Bellomo R, Lipman J, et al.: Adult-population incidence of severe sepsis in Australian and New Zealand intensive care units. Intensive Care Med 2004, 30:589–596. [Published erratum appears in Intensive Care Med 2004, 30:1252.] Interesting study on the incidence of sepsis in the general population of Australia and New Zealand.
van Gestel A, Bakker J, Veraart CP, van Hout BA: Prevalence and incidence of severe sepsis in Dutch intensive care units. Crit Care 2004, 8:R153-R162. Epidemiology of sepsis in ICU patients the Netherlands.
Annane D, Aegerter P, Jars-Guincestre MC, Guidet B: Current epidemiology of septic shock: the CUB-Rea Network. Am J Respir Crit Care Med 2003, 168:165–172. Massive retrospective study on the epidemiology of septic shock in France.
Silva E, Pedro Mde A, Sogayar AC, et al.: Brazilian Sepsis Epidemiological Study (BASES study). Crit Care 2004, 8:R251-R260. Epidemiology of sepsis in ICU patients Brazil.
Padkin A, Goldfrad C, Brady AR, et al.: Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland. Crit Care Med 2003, 31:2332–2338.
Harrison DA, Welch CA, Eddleston JM: 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 2006, 10:R42, Epub ahead of print. Secondary analysis of the ICNARC database with an interesting perspective on temporal trends.
Alberti C, Brun-Buisson C, Burchardi H, et al.: Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med 2002, 28:108–121.
Vincent JL, Sakr Y, Sprung CL, et al.: Sepsis in European intensive care units: Results of the SOAP study. Crit Care Med 2006, 34:344–353. Recent multicenter study on the epidemiology of sepsis.
Moreno R, Matos R, Fevereiro T, Pereira ME. À procura de um índice de gravidade na sépsis. Rev Port Med Intensiva 1999, 8:43–52.
Metnitz PG, Moreno RP, Almeida E, et al.: SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description. Intensive Care Med 2005, 31:1336–1344. Epidemiological description of the cohort used to build up the SAPS 3 admission prognostic model.
Moreno RP, Metnitz PG, Almeida E, et al.: SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med 2005, 31:1345–1355. Interesting data on international differences in outcomes in the ICU.
Lee WL, Ferguson ND: SOAP and sepsis—analyzing what comes out in the wash. Crit Care Med 2006, 34:344–353.
Sundararajan V, Macisaac CM, Presneill JJ, et al.: Epidemiology of sepsis in Victoria, Australia. Crit Care Med 2005, 33:71–80.
Flaatten H: Epidemiology of sepsis in Norway in 1999. Crit Care 2004, 8:R180-R184. Epidemiological description in all hospital admissions in Norway.
Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003, 348:1546–1554. Important information on trends of infection and sepsis in the United States over time.
Dellinger RP, Carlet JM, Masur H, et al.: Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock. Intensive Care Med 2004, 30:536–555.
Brun-Buisson C, Meshaka P, Pinton P, Vallet B: EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 2004, 30:580–588. Epidemiological study of sepis in French ICUs.
Watson RS, Carcillo JA, Linde-Zwirble WT, et al.: The Epidemiology of Severe Sepsis in Children in the United States. Am J Respir Crit Care Med 2003, 167:695–701.
Edbrooke DL, Hibbert CL, Kingsley JM, et al.: The patientrelated costs of care for sepsis patients in a United Kingdom adult general intensive care unit. Crit Care Med 1999, 27:1760–1767.
Weycker D, Akhras KS, Edelsberg J, et al.: Long-term mortality and medical care charges in patients with severe sepsis. Crit Care Med 2003, 31:2316–2323.
Friedman G, Silva E, Vincent JL: Has the mortality of septic shock changed with time? Crit Care Med 1998, 26:2078–2086.
Alberti C, Brun-Buisson C, Goodman SV, et al.: Influence of systemic inflammatory response syndrome and sepsis on outcome of critically ill infected patients. Am J Respir Crit Care Med 2003, 168:77–84.
Alberti C, Brun-Buisson C, Chevret S, et al.: Systemic Inflammatory Response and Progression to Severe Sepsis in Critically Ill Infected Patients. Am J Respir Crit Care Med 2005, 171:461–468. Can we predict risk of progression from sepsis to severe sepsis and septic shock?
Rangel-Frausto MS: The epidemiology of bacterial sepsis. Infect Dis Clin North Am 1999, 13:299–312.
Opal SM, Cohen J: Clinical gram-positive sepsis: does it fundamentally differ from Gram-negative bacterial sepsis? Crit Care Med 1999, 27:1608–1616.
Laupland KB, Zygun DA, Doig CJ, et al.: One-year mortality of bloodstream infection-associated sepsis and septic shock among patients presenting to a regional critical care system. Intensive Care Med 2005, 31:213–219.
Sasse KC, Nauenberg E, Long A, et al.: Long-term survival after intensive care unit admission with sepsis. Crit Care Med 1995, 23:1040–1047.
Niskanen M, Kari A, Halonen P: Five-year survival after intensive care—comparison of 12,180 patients with the general population. Crit Care Med 1996, 24:1962–1967.
Carlet J: Prescribing indications based on successful clinical trials in sepsis: a difficult exercise. Crit Care Med 2006, 34:525–529.
Angus DC, Wax RS: Epidemiology of sepsis: an update. Crit Care Med 2001, 29:S109-S16.
Sprung CL, Sakr Y, Vincent JL, et al.: An evaluation of systemic inflammatory response syndrome signs in the Sepsis Occurrence in Acutely ill Patients (SOAP) study. Intensive Care Med 2006, 32:421–427. The impact of SIRS criteria on mortality from sepsis.
Calandra T, Cohen J, for the International Sepsis Forum Definition of Infection in the ICU Consensus Conference: The International Sepsis Forum Consensus Conference on Definitions of Infection in the Intensive Care Unit. Crit Care Med 2005, 33:1538–1548.
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Moreno, R., Afonso, S. & Fevereiro, T. Incidence of sepsis in hospitalized patients. Curr Infect Dis Rep 8, 346–350 (2006). https://doi.org/10.1007/s11908-006-0044-2
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DOI: https://doi.org/10.1007/s11908-006-0044-2