Chia-Hung Yo1, Chih-Cheng Lai2, Tzu-Chun Hsu3, Cheng-Yi Wang4,5, Alvaro E Galvis6, Debra Yen7, Wan-Ting Hsu8, Jason Wang2, Chien-Chang Lee9. 1. Far Eastern Memorial Hospital Department of Emergency Medicine New Taipei City Taiwan. 2. Kaohsiung Veterans General Hospital, Tainan Branch, Department of Internal Medicine Tainan Taiwan. 3. National Taiwan University Hospital Department of Emergency Medicine Taipei Taiwan. 4. Cardinal Tien Hospital and School of Medicine Department of Internal Medicine New Taipei City Taiwan. 5. Fu Jen Catholic University College of Medicine New Taipei City Taiwan. 6. Children's Hospital of Orange County, University of California Department of Infectious Diseases Orange CA USA. 7. Washington University School of Medicine Department of Medicine Saint Louis MO USA. 8. Harvard T.H. Chan School of Public Health Department of Epidemiology Boston MA USA. 9. University of Nevada Las Vegas School of Medicine Department of Pediatrics Nevada USA.
Abstract
BACKGROUND: Little is known about the trend of incidence and mortality of specific organ dysfunction among sepsis patients at the population level. This study aimed to examine the trend and mortality of organ dysfunction in patients with sepsis using a nationwide database in Taiwan. METHODS: We conducted a study using 2002-2012 data from the nationwide health insurance database of Taiwan. Sepsis hospitalizations were identified by Angus algorithm to include all cases with ICD-9-CM codes for specific sepsis diagnosis and both an infectious process and a diagnosis of acute organ dysfunction. The primary outcome was the trend of incidence and in-hospital mortality of specific type of organ dysfunction in sepsis patients. RESULTS: We identified 1,259,578 adult patients with sepsis. Acute respiratory dysfunction, cardiovascular dysfunction/shock, and renal system dysfunction were the leading three types of acute organ dysfunction, accounting for 65.6, 30.5, and 18.3% of all sepsis patients, respectively. All types of organ dysfunction increased over time, except for hepatic and metabolic systems. Renal system (annual increase: 13.5%) and cardiovascular system dysfunction (annual increase: 4.3%) had the fastest increase. Mortality from all sources of infection has decreased significantly in the study period (trend p < 0.001). CONCLUSIONS: This is the first true nationwide population-based data showing the trend and outcome of acute organ dysfunction in sepsis patients. Renal and cardiovascular systems dysfunction are increasing at an alarming rate.
BACKGROUND: Little is known about the trend of incidence and mortality of specific organ dysfunction among sepsis patients at the population level. This study aimed to examine the trend and mortality of organ dysfunction in patients with sepsis using a nationwide database in Taiwan. METHODS: We conducted a study using 2002-2012 data from the nationwide health insurance database of Taiwan. Sepsis hospitalizations were identified by Angus algorithm to include all cases with ICD-9-CM codes for specific sepsis diagnosis and both an infectious process and a diagnosis of acute organ dysfunction. The primary outcome was the trend of incidence and in-hospital mortality of specific type of organ dysfunction in sepsis patients. RESULTS: We identified 1,259,578 adult patients with sepsis. Acute respiratory dysfunction, cardiovascular dysfunction/shock, and renal system dysfunction were the leading three types of acute organ dysfunction, accounting for 65.6, 30.5, and 18.3% of all sepsis patients, respectively. All types of organ dysfunction increased over time, except for hepatic and metabolic systems. Renal system (annual increase: 13.5%) and cardiovascular system dysfunction (annual increase: 4.3%) had the fastest increase. Mortality from all sources of infection has decreased significantly in the study period (trend p < 0.001). CONCLUSIONS: This is the first true nationwide population-based data showing the trend and outcome of acute organ dysfunction in sepsis patients. Renal and cardiovascular systems dysfunction are increasing at an alarming rate.
Authors: Bram Rochwerg; Waleed Alhazzani; Anees Sindi; Diane Heels-Ansdell; Lehana Thabane; Alison Fox-Robichaud; Lawrence Mbuagbaw; Wojciech Szczeklik; Fayez Alshamsi; Sultan Altayyar; Wang-Chun Ip; Guowei Li; Michael Wang; Anna Wludarczyk; Qi Zhou; Gordon H Guyatt; Deborah J Cook; Roman Jaeschke; Djillali Annane Journal: Ann Intern Med Date: 2014-09-02 Impact factor: 25.391
Authors: R Phillip Dellinger; Jean M Carlet; Henry Masur; Herwig Gerlach; Thierry Calandra; Jonathan Cohen; Juan Gea-Banacloche; Didier Keh; John C Marshall; Margaret M Parker; Graham Ramsay; Janice L Zimmerman; Jean-Louis Vincent; Mitchell M Levy Journal: Crit Care Med Date: 2004-03 Impact factor: 7.598