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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2013 September;79(9):993-1002
Epidemiology and outcome of sepsis syndromes in Italian ICUs: a multicentre, observational cohort study in the region of Piedmont
Sakr Y. 1, Elia C. 2, Mascia L. 2, Barberis B. 3, Cardellino S. 4, Livigni S. 5, Fiore G. 6, Filippini C. 2, Ranieri V. M. 2 ✉
1 Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University, Jena, Germany;
2 Department of Anesthesiology and Intensive Care, San Giovanni Battista-Molinette Hospital, University of Torino, Torino, Italy;
3 Department of Anesthesiology and Intensive Care, Ospedale degli Infermi, Rivoli, Torino, Italy;
4 Department of Anesthesiology and Intensive Care, Ospedale Cardinal Massaia, Asti, Italy;
5 Department of Anesthesiology and Intensive Care, Ospedale San Giovanni Bosco, Torino, Italy;
6 Department of Anesthesiology and Intensive Care, Ospedale Santa Croce, Moncalieri, Torino, Italy
Background: Sepsis is an important cause of mortality and morbidity in the intensive care unit (ICU). We performed a study to describe the epidemiology of sepsis syndromes in patients admitted toICUs of the Piedmont region.
Methods: In this prospective, multicentre, observational study, all 3902 patients admitted to a network of 24 ICUs from 17 hospitals during a 180 day period (April 3-September 29, 2006) were included. Patients were followed from the first day of admission until death or ICU discharge.
Results: The incidence of sepsis during the ICU stay was 11.4% (N.=446), corresponding to an incidence of 25 cases/100,000 inhabitants/year; 141 (31.6%) patients had only sepsis, 160 patients had severe sepsis (35.9%) and 145 patients (32.5%) had septic shock In 227 patients (50.9%), sepsis was observed within 48 hours after admission to the ICU, and 219 patients (49.1%) developed ICU-acquired sepsis. The main sources of infection were the lungs, abdomen, and urinary tract. ICU mortality was higher (41.3 vs. 17.3%, P<0.0001) and the median ICU length of stay longer (15 vs. 2 days, P<0.0001) in patients with sepsis than in those without sepsis. The mortality rate increased with the severity of sepsis. ICU-acquired sepsis was associated with higher ICU mortality rates than sepsis occurring within 48 hours of ICU admission (49.8 vs. 33.0%, P<0.0001).
Conclusion: Sepsis is a common occurrence in critically ill patients. Our data underscore the regional variability in the epidemiology and outcome of sepsis syndromes and may be useful to guide appropriate resource allocation.