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Sepsis in intensive care unit patients: Worldwide data from the ICON audit

Sakr, Yasser, Jaschinski, Ulrich, Wittebole, Xavier, Szakmany, Tamas, Lipman, Jeffrey, Ñamendys-Silva, Silvio A, Martin-Loeches, Ignacio, Leone, Marc, Lupu, Mary-Nicoleta and Vincent, Jean-Louis 2018. Sepsis in intensive care unit patients: Worldwide data from the ICON audit. Open Forum Infectious Diseases 5 (12) , ofy313. 10.1093/ofid/ofy313

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Abstract

Background There is a need to better define the epidemiology of sepsis in ICUs around the globe. Methods The ICON (Intensive Care over Nations) 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 10,069 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 2,973 (29.5%) patients, including in 1,808 (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 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 SAPS II score, comorbid cancer, chronic heart failure (NYHA 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, associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Oxford University Press
ISSN: 2328-8957
Date of First Compliant Deposit: 29 November 2018
Date of Acceptance: 19 November 2018
Last Modified: 27 Jun 2019 21:13
URI: http://orca.cf.ac.uk/id/eprint/117197

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