The costs of septic syndromes in the intensive care unit and influence of hospital-acquired sepsis.
OBJECTIVE
To document the costs and outcomes of the various forms of the septic syndromes [systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock), particularly those associated with infection acquired in an intensive care unit (ICU).


METHODS
Prospective data collection for all septic patients admitted to a medical ICU during a 1-year period. Costs were computed from the viewpoint of the hospital.


RESULTS
Mean total hospital costs were Euro 26,256, Euro 35,185, and Euro 27,083 for patients with sepsis, severe sepsis, and septic shock, respectively. Total costs varied slightly according to the site of infection and the severity of sepsis but were influenced mostly by its mode of acquisition: patients having sepsis associated with ICU-acquired infection incurred total costs about three times those of patients presenting with infection and sepsis on ICU admission (from Euro 39,908 in patients with ICU acquired sepsis to Euro 44,851 in patients with ICU-acquired septic shock). Stratifying patients by the presence of ICU-acquired infection also showed that a first episode of infection complicated by ICU-acquired sepsis incurred at least 2.5 times more costs than a single episode of sepsis.


CONCLUSIONS
In this series the medical costs of sepsis were not markedly influenced by its severity but by its mode of acquisition. Due to wide variations in ICU costs cost-effectiveness analyses of treatments for sepsis should document the case-mix of patients and the contribution to this of nosocomial infections.
Brun-Buisson
Christian
C
Medical Intensive Care Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris 12, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France. christian.brun-buisson@hmn.ap-hop-paris.fr
Roudot-Thoraval
Françoise
F
Girou
Emmanuelle
E
Grenier-Sennelier
Catherine
C
Durand-Zaleski
Isabelle
I
D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics* / Q000706:statistics & numerical data; D003428:Cross Infection / Q000191:economics* / Q000628:therapy*; D005260:Female; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D018805:Sepsis / Q000191:economics* / Q000628:therapy*; D012772:Shock, Septic / Q000191:economics / Q000628:therapy; D018746:Systemic Inflammatory Response Syndrome / Q000191:economics / Q000628:therapy