1. Trends in mortality in septic patients according to the different organ failure during 15 years
- Author
-
Lorencio Cárdenas, Carolina, Yébenes, Juan Carlos, Vela, Emili, Clèries, Montserrat, Sirvent, Josep Mª, Fuster-bertolín, Cristina, Reina, Clara, Rodríguez, Alejandro, Ruiz-rodríguez, Juan Carlos, Trenado, Josep, Esteban Torné, Elisabeth, Institut Català de la Salut, [Lorencio Cárdenas C] Intensive Care Department, Hospital Universitari Dr. Josep Trueta, Girona, Spain. Universitat de Girona, Girona, Spain. [Yébenes JC] Intensive Care Department, Hospital de Mataró, Mataró, Spain. [Vela E, Clèries M] Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain. Àrea de Sistemes d’informació, Servei Català de la Salut (CatSalut), Barcelona, Spain. [Sirvent JM, Fuster-Bertolín C] Intensive Care Department, Hospital Universitari Dr. Josep Trueta, Girona, Spain. [Ruiz-Rodríguez JC] Unitat de Cures Intensives, Grup de Recerca de Shock, Disfunció Orgànica i Ressuscitació, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
afecciones patológicas, signos y síntomas::procesos patológicos::choque::insuficiencia multiorgánica [ENFERMEDADES] ,Multiple Organ Failure ,Pathological Conditions, Signs and Symptoms::Pathologic Processes::Shock::Multiple Organ Failure [DISEASES] ,Xoc sèptic ,infecciones bacterianas y micosis::infección::sepsis [ENFERMEDADES] ,Critical Care and Intensive Care Medicine ,Shock, Septic ,Fallida multiorgànica ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,Septic shock ,Sepsis ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad::mortalidad hospitalaria [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Humans ,Septicèmia - Complicacions ,Bacterial Infections and Mycoses::Infection::Sepsis [DISEASES] ,Hospital Mortality ,Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Retrospective Studies ,Septicèmia - Mortalitat ,Other subheadings::Other subheadings::/complications [Other subheadings] - Abstract
Background The incidence of sepsis can be estimated between 250 and 500 cases/100.000 people per year and is responsible for up to 6% of total hospital admissions. Identified as one of the most relevant global health problems, sepsis is the condition that generates the highest costs in the healthcare system. Important changes in the management of septic patients have been included in recent years; however, there is no information about how changes in the management of sepsis-associated organ failure have contributed to reduce mortality. Methods A retrospective analysis was conducted from hospital discharge records from the Minimum Basic Data Set Acute-Care Hospitals (CMBD-HA in Catalan language) for the Catalan Health System (CatSalut). CMBD-HA is a mandatory population-based register of admissions to all public and private acute-care hospitals in Catalonia. Sepsis was defined by the presence of infection and at least one organ dysfunction. Patients hospitalized with sepsis were detected, according ICD-9-CM (since 2005 to 2017) and ICD-10-CM (2018 and 2019) codes used to identify acute organ dysfunction and infectious processes. Results Of 11.916.974 discharges from all acute-care hospitals during the study period (2005–2019), 296.554 had sepsis (2.49%). The mean annual sepsis incidence in the population was 264.1 per 100.000 inhabitants/year, and it increased every year, going from 144.5 in 2005 to 410.1 in 2019. Multiorgan failure was present in 21.9% and bacteremia in 26.3% of cases. Renal was the most frequent organ failure (56.8%), followed by cardiovascular (24.2%). Hospital mortality during the study period was 19.5%, but decreases continuously from 25.7% in 2005 to 17.9% in 2019 (p p p Conclusions The incidence of sepsis has been increasing in recent years in our country. However, hospital mortality has been significantly reduced. In septic patients, all organ failures except liver have shown a statistically significant reduction on associated mortality, with cardiovascular failure as the most relevant.
- Published
- 2022