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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.