Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit

There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for le...

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Published in:Open forum infectious diseases Vol. 5; no. 12; p. ofy313
Main Authors: Sakr, Yasser, Jaschinski, Ulrich, Wittebole, Xavier, Szakmany, Tamas, Lipman, Jeffrey, Ñamendys-Silva, Silvio A, Martin-Loeches, Ignacio, Leone, Marc, Lupu, Mary-Nicoleta, Vincent, Jean-Louis
Format: Journal Article
Language:English
Published: United States Oxford University Press 01.12.2018
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ISSN:2328-8957, 2328-8957
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Abstract There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary. The audit included 10069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with spp. Sepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.
AbstractList There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe.BACKGROUNDThere is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe.The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary.METHODSThe Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary.The audit included 10069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with Acinetobacter spp.RESULTSThe audit included 10069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with Acinetobacter spp.Sepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.CONCLUSIONSSepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.
Background There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. Methods The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary. Results The audit included 10069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with Acinetobacter spp. Conclusions Sepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.
There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary. The audit included 10069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with spp. Sepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.
Author Szakmany, Tamas
Wittebole, Xavier
Lipman, Jeffrey
Martin-Loeches, Ignacio
Vincent, Jean-Louis
Jaschinski, Ulrich
Leone, Marc
Ñamendys-Silva, Silvio A
Sakr, Yasser
Lupu, Mary-Nicoleta
AuthorAffiliation 9 Department of Anesthesia and Intensive Care, Spitalul Clinic Judetean de Urgenta “Sfantul Apostol Andrei”, Galati, Romania
2 Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Germany
7 Department of Clinical Medicine, Trinity Centre for Health Sciences, Multidisciplinary Intensive Care Research Organization, Wellcome Trust, Health Research Board-Clinical Research, St. James’s University Hospital Dublin, Ireland
8 Aix Marseille Université, Assistance Publique Hpitaux de Marseille, Service d’Anesthésie et de Réanimation, Hôpital Nord, Marseille, France
4 Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Wales, United Kingdom
3 Department of Critical Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
5 Intensive Care Services, Royal Brisbane and Women’s Hospital, The University of Queensland, Australia
1 Department of Anaesthesiology and Intensive Care, Uniklini
AuthorAffiliation_xml – name: 3 Department of Critical Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
– name: 2 Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Germany
– name: 9 Department of Anesthesia and Intensive Care, Spitalul Clinic Judetean de Urgenta “Sfantul Apostol Andrei”, Galati, Romania
– name: 7 Department of Clinical Medicine, Trinity Centre for Health Sciences, Multidisciplinary Intensive Care Research Organization, Wellcome Trust, Health Research Board-Clinical Research, St. James’s University Hospital Dublin, Ireland
– name: 10 Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
– name: 8 Aix Marseille Université, Assistance Publique Hpitaux de Marseille, Service d’Anesthésie et de Réanimation, Hôpital Nord, Marseille, France
– name: 1 Department of Anaesthesiology and Intensive Care, Uniklinikum Jena, Germany
– name: 4 Department of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Cardiff University, Wales, United Kingdom
– name: 5 Intensive Care Services, Royal Brisbane and Women’s Hospital, The University of Queensland, Australia
– name: 6 Department of Critical Care Medicine, Instituto Nacional de Cancerología, Ciudad de México
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  surname: Sakr
  fullname: Sakr, Yasser
  organization: Department of Anaesthesiology and Intensive Care, Uniklinikum Jena, Germany
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  fullname: Jaschinski, Ulrich
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– sequence: 3
  givenname: Xavier
  surname: Wittebole
  fullname: Wittebole, Xavier
  organization: Department of Critical Care, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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  surname: Szakmany
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  organization: Intensive Care Services, Royal Brisbane and Women’s Hospital, The University of Queensland, Australia
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  surname: Martin-Loeches
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  givenname: Mary-Nicoleta
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– sequence: 10
  givenname: Jean-Louis
  surname: Vincent
  fullname: Vincent, Jean-Louis
  organization: Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30555852$$D View this record in MEDLINE/PubMed
https://amu.hal.science/hal-02439048$$DView record in HAL
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Snippet There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. The Intensive Care over Nations (ICON) audit...
Background There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. Methods The Intensive Care over Nations...
There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe.BACKGROUNDThere is a need to better define the...
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StartPage ofy313
SubjectTerms Bacteriology
Cardiology and cardiovascular system
Emerging diseases
Human health and pathology
Infectious diseases
Intensive care
Life Sciences
Major
Microbiology and Parasitology
Mortality
Parasitology
Sepsis
Virology
Title Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit
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https://amu.hal.science/hal-02439048
https://pubmed.ncbi.nlm.nih.gov/PMC6289022
Volume 5
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