Current epidemiology of septic shock: the CUB-Réa Network.
To update the epidemiology of septic shock we analyzed clinical, microbiologic, and outcome variables from 100,554 intensive care unit admissions on the Collège des Utilisateurs de Bases de données en Réanimation (CUB-Réa) database, collected from 22 hospitals over a 8-year period, 1993 to 2000. The overall frequency of septic shock was 8.2 per 100 admissions (i.e., 8,251 stays). It increased from 7.0 (in 1993) to 9.7 per 100 admissions (in 2000). The distribution analysis of the sites of infection and of the types of pathogens showed an increase in the rate of pulmonary infection (p = 0.001) and of multiresistant bacteria-related septic shock (p = 0.001). The crude mortality was 60.1% and declined from 62.1% (in 1993) to 55.9 (in 2000) (p = 0.001). As compared with matched intensive care unit admissions without sepsis, the excess risk of death due to septic shock was 25.7 (95% confidence interval, 24.0-27.3) and the matched odds ratio of death was 3.9 (95% confidence interval, 3.5-4.3). The frequency of septic shock is increasing with more multiresistant strains. Its crude mortality rate is decreasing, but patients with septic shock still have a high excess risk of death than critically ill patients who are nonseptic.
Annane
Djillali
D
Service de Réanimation Médicale, Hôpital Raymond Poincaré, Faculté de Médecine Paris Ile de France Ouest, Université de Versaille Saint Quentinen-Yvelinnes, 104, Boulevard Raymond Poincaré, 92380 Garches, France. djillali.annane@rpc.ap-hop-paris.fr
Aegerter
Philippe
P
Jars-Guincestre
Marie Claude
MC
Guidet
Bertrand
B
D015897:Comorbidity; D016208:Databases, Factual; D018432:Drug Resistance, Multiple; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D000091402:Prohibitins; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D015996:Survival Rate