TY - JOUR
T1 - Temporal trends in patient characteristics and survival of intensive care admissions with sepsis
T2 - A multicenter analysis*
AU - Dreiher, Jacob
AU - Almog, Yaniv
AU - Sprung, Charles L.
AU - Codish, Shlomi
AU - Klein, Moti
AU - Einav, Sharon
AU - Bar-Lavie, Yaron
AU - Singer, Pierre P.
AU - Nimrod, Adi
AU - Sachs, Jeffrey
AU - Talmor, Daniel
AU - Friger, Michael
AU - Greenberg, Dan
AU - Olsfanger, David
AU - Hersch, Moshe
AU - Novack, Victor
PY - 2012/3/1
Y1 - 2012/3/1
N2 - OBJECTIVE: To estimate in-hospital, 1-yr, and long-term mortality and to assess time trends in incidence and outcomes of sepsis admissions in the intensive care unit. DESIGN: A population-based, multicenter, retrospective cohort study. PATIENTS: Patients hospitalized with sepsis in the intensive care unit in seven general hospitals in Israel during 2002-2008. INTERVENTIONS: None. MEASUREMENTS: Survival data were collected and analyzed according to demographic and background clinical characteristics, as well as features of the sepsis episode, using Kaplan-Meier approach for long-term survival. MAIN RESULTS: A total of 5,155 patients were included in the cohort (median age: 70, 56.3% males; median Charlson comorbidity index: 4). The mean number of intensive care unit admissions per month increased over time, while no change in in-hospital mortality was observed. The proportion of patients surviving to hospital discharge was 43.9%. The 1-, 2-, 5-, and 8-yr survival rates were 33.0%, 29.8%, 23.3%, and 19.8%, respectively. Mortality was higher in older patients, patients with a higher Charlson comorbidity index, and those with multiorgan failure, and similar in males and females. One-year age-standardized mortality ratio was 21-fold higher than expected, based on the general population rates. CONCLUSIONS: Mortality following intensive care unit sepsis admission remains high and is correlated with underlying patients' characteristics, including age, comorbidities, and the number of failing organ systems.
AB - OBJECTIVE: To estimate in-hospital, 1-yr, and long-term mortality and to assess time trends in incidence and outcomes of sepsis admissions in the intensive care unit. DESIGN: A population-based, multicenter, retrospective cohort study. PATIENTS: Patients hospitalized with sepsis in the intensive care unit in seven general hospitals in Israel during 2002-2008. INTERVENTIONS: None. MEASUREMENTS: Survival data were collected and analyzed according to demographic and background clinical characteristics, as well as features of the sepsis episode, using Kaplan-Meier approach for long-term survival. MAIN RESULTS: A total of 5,155 patients were included in the cohort (median age: 70, 56.3% males; median Charlson comorbidity index: 4). The mean number of intensive care unit admissions per month increased over time, while no change in in-hospital mortality was observed. The proportion of patients surviving to hospital discharge was 43.9%. The 1-, 2-, 5-, and 8-yr survival rates were 33.0%, 29.8%, 23.3%, and 19.8%, respectively. Mortality was higher in older patients, patients with a higher Charlson comorbidity index, and those with multiorgan failure, and similar in males and females. One-year age-standardized mortality ratio was 21-fold higher than expected, based on the general population rates. CONCLUSIONS: Mortality following intensive care unit sepsis admission remains high and is correlated with underlying patients' characteristics, including age, comorbidities, and the number of failing organ systems.
KW - intensive care
KW - long-term survival
KW - mortality
KW - outcome assessment
KW - sepsis
KW - septic shock
UR - http://www.scopus.com/inward/record.url?scp=84857554756&partnerID=8YFLogxK
U2 - 10.1097/CCM.0b013e318236f7b8
DO - 10.1097/CCM.0b013e318236f7b8
M3 - Article
C2 - 22020241
AN - SCOPUS:84857554756
SN - 0090-3493
VL - 40
SP - 855
EP - 860
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 3
ER -