Sepsis and septic shock in France: incidences, outcomes and costs of care

Annals of Intensive Care

Gregory Papin¹  Damien Van-Gysel²  Sébastien Bailly³  Camille Vinclair⁴  Claire Dupuis⁵  Bruno Mourvillier⁶  Fabrice Sinnah⁷  Sonia Abid⁷  Stéphane Ruckly⁸  Arthur Mageau⁸  Anne Perozziello⁸  Lila Bouadma⁹  Romain Sonneville⁹  Etienne de Montmollin⁹  Jean-François Timsit⁹ 

[1] Department of Anaesthesia and Intensive Care, Bichat Claude Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France;Département D’Informations Médicales, Bichat Claude Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France;HP2 Laboratory, INSERM U1042, Univ. Grenoble Alpes, Grenoble, France;EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France;Intensive Care Unit, Centre Hospitalier de La Côte Basque, 64109, Bayonne, France;Medical Intensive Care Unit, Gabriel Montpied University Hospital, Clermont-Ferrand, France;UMR 1137-IAME Team 5–DeSCID: Decision Sciences in Infectious Diseases control and care INSERM/Univ Paris Diderot, Sorbonne Paris Cité, 75018, Paris, France;Medical Intensive Care Unit, Robert Debré University Hospital, Rue du Général Koenig, 51100, Reims, France;Medical and Infectious Diseases Intensive Care Unit, Bichat Claude Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France;UMR 1137-IAME Team 5–DeSCID: Decision Sciences in Infectious Diseases control and care INSERM/Univ Paris Diderot, Sorbonne Paris Cité, 75018, Paris, France;UMR 1137-IAME Team 5–DeSCID: Decision Sciences in Infectious Diseases control and care INSERM/Univ Paris Diderot, Sorbonne Paris Cité, 75018, Paris, France;Medical and Infectious Diseases Intensive Care Unit, Bichat Claude Bernard University Hospital, AP-HP, 46 rue Henri Huchard, 75018, Paris, France;

关键词: Sepsis;    Septic shock;    Epidemiology;    Secular trends;   

DOI  :  10.1186/s13613-020-00760-x

来源: Springer

【 摘 要 】

BackgroundSepsis is one of the leading causes of death worldwide. The associated incidence, mortality and trends do not differ greatly between documented reports. The purpose of this study was to provide an in-depth description of patients with sepsis and septic shock hospitalized in France from 2010 to 2015 and to explore the temporal trends of their clinical characteristics, costs and outcomes.MethodsRetrospective cohort study of the French hospital administrative database in which organ failure therapies and severity scores are systematically registered. All patients admitted between 2010 and 2015 for sepsis and septic shock as defined by an ICD-10 code for infection, and for organ failure or the use of organ failure supplementation were included. Incidence, outcomes and trends were analyzed. Subgroup analyses based on several coding strategies and adjusted for severity scores were performed.ResultsA total of 737,147 patients with sepsis and 492,902 patients with septic shock were included. From 2010 to 2015, the incidence of sepsis and septic shock increased, respectively, from 206 to 243 and from 135 to 171 cases per 100,000 population. Case fatality remained at 34% for sepsis, but decreased from 46 to 44% for septic shock.Median hospital stay costs amounted to €11,400 (IQR: 5036; 24,364) for patients with sepsis and €16,439 (IQR: 7339; 29,360) for patients with septic shock.After adjustment for case-mix and illness severity, the risk of death was stable for sepsis (0.08% [− 0.04; 0.20] per year), but decreased for sepsis patients admitted to the intensive care unit and for cases of septic shock (− 0.33%[ − 0.40; − 0.27] per year).ConclusionsSepsis is common, frequently fatal and expensive to treat. Its incidence has increased. Case fatality has decreased in most severely affected patients, owing partly to general improvements in care.

【 授权许可】

CC BY