Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study.
OBJECTIVE
To determine the incidence and outcome of severe sepsis in the adult Finnish population and to evaluate how treatment guidelines in severe sepsis are applied in clinical practice.


METHODS
A prospective study in 24 closed multidisciplinary ICUs in 21 hospitals (4 university and 17 tertiary hospitals) in Finland.


METHODS
All 4,500 consecutive ICU admission episodes were screened for severe sepsis during a 4-month period (1 November 2004 - 28 February 2005). The referral population was 3,743,225.


RESULTS
The severe sepsis criteria were fulfilled in 470 patients, who had 472 septic episodes. The incidence of severe sepsis in the ICUs in Finland was 0.38/1000 in the adult population (95% confidence interval 0.34-0.41). The mean ICU length of stay was 8.2+/-8.1 days. ICU, hospital, and 1-year mortality rates were 15.5%, 28.3%, and 40.9%, respectively. Respiratory failure requiring ventilation support was the most common organ failure (86.2%); septic shock was present in 77% and acute renal failure in 20.6% of cases. Activated protein C was given to only 15 of the 55 patients with indication (27%) and low-dose corticosteroids to 150 of 366 (41%) patients with septic shock.


CONCLUSIONS
This prospective study found the incidence of ICU-treated severe sepsis in Finland to be 0.38 per 1,000 of the population. The ICU and hospital mortalities were also lower than earlier reported in United States or Australia. Evidence-based sepsis therapies were not used as often as recommended.
Karlsson
Sari
S
Aurinkokatu 3B38, 13100, Hämeenlinna, Finland. sari.karlsson@pshp.fi
Varpula
Marjut
M
Ruokonen
Esko
E
Pettilä
Ville
V
Parviainen
Ilkka
I
Ala-Kokko
Tero I
TI
Kolho
Elina
E
Rintala
Esa M
EM
D000328:Adult; D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D019983:Guideline Adherence; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D012772:Shock, Septic / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome