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Kosten der Sepsis

The cost of sepsis

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Zusammenfassung

In den letzten Jahren wurden auf dem Gebiet der Sepsisforschung große Fortschritte gemacht. Trotz des wachsenden Verständnisses für die pathophysiologischen Zusammenhänge und neuer therapeutischer Optionen, stellt die Sepsis allerdings weiterhin ein erhebliches Problem dar. Pro Jahr erkranken in Deutschland schätzungsweise 75.000 Patienten an einer schweren Sepsis; in den USA sind es bis zu 750.000. Die Kosten der Intensivtherapie sind bei diesem Patientengut aufgrund langer Verweildauern und aufwändiger Therapien außerordentlich hoch. Ergänzt man die indirekten Kosten, die der Gesellschaft z. B. durch den Krankheitsausfall entstehen, dann resultiert infolge der hohen Inzidenz insgesamt eine beachtliche sozioökonomische Belastung. In Deutschland betragen die jährlichen Kosten der Sepsis für die Gesellschaft schätzungsweise zwischen EUR 3,6 und 7,8 Mrd. Die schwere Sepsis ist somit nicht nur aus der Perspektive der Intensivstation oder des Krankenhauses, sondern auch aus gesundheitsökonomischer Sicht von beträchtlicher Relevanz. Neue Medikamente, wie aktiviertes Protein C, und therapeutische Strategien, wie die intensivierte Insulintherapie, sind erfolgversprechend und werden in Zukunft wahrscheinlich eine wichtige Rolle in der Behandlung der schweren Sepsis spielen. Obwohl ihre Kosteneffektivität teilweise erwiesen scheint, stellen sie den Intensivmediziner jedoch vor eine nicht unerhebliche ökonomische Belastung. In der folgenden Übersicht werden Studien, die sich mit den direkten oder indirekten Kosten der Sepsis beschäftigen, vorgestellt, und die Kosteneffektivität innovativer Therapien wird diskutiert.

Abstract

In recent years great efforts in clinical sepsis research have led to a better understanding of the underlying pathophysiology and new therapeutic approaches including drugs and supportive care. Despite this success, severe sepsis remains a serious health care problem. Each year approximately 75,000 patients in Germany and approximately 750,000 patients in the USA suffer from severe sepsis. The length of stay and the cost of laborious therapies lead to high intensive care unit (ICU) costs. Sepsis causes a significant national socioeconomic burden if indirect costs due to productivity loss are included and in Germany severe sepsis has been estimated to generate costs between 3.6 and 7.7 billion Euro annually. Thus, this complex and life-threatening disease has been identified as a high cost driver not only for the ICU, but also from the perspectives of hospitals and society. To improve the outcome of severe sepsis, innovative drugs and treatment strategies are urgently needed. Some drugs and strategies already offer promising results and will probably play a major role in the future. Even though their cost-effectiveness is likely, intensive care medicine has to carry a substantial economic burden. This article summarizes studies focusing on the evaluation of direct or indirect costs of sepsis and the cost-effectiveness of new therapies.

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  1. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität, Göttingen

    H. Burchardi

  2. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität, Robert-Koch-Str. 40, 37099, Göttingen

    O. Moerer

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  2. H. Burchardi
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Moerer, O., Burchardi, H. Kosten der Sepsis. Anaesthesist 55 (Suppl 1), 36–42 (2006). https://doi.org/10.1007/s00101-006-1039-y

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