title: Epidemiology of sepsis in Germany: results from a national prospective multicenter study.
abstract: OBJECTIVE
  To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size.
  
  
  METHODS
  Prospective, observational, cross-sectional 1-day point-prevalence study.
  
  
  METHODS
  454 ICUs from a representative nationwide sample of 310 hospitals stratified by size. Data were collected via 1-day on-site audits by trained external study physicians. Visits were randomly distributed over 1 year (2003).
  
  
  METHODS
  Inflammatory response of all ICU patients was assessed using the ACCP/SCCM consensus conference criteria. Patients with severe sepsis were followed up after 3 months for hospital mortality and length of ICU stay.
  
  
  RESULTS
  Main outcome measures were prevalence and mortality. A total of 3,877 patients were screened. Prevalence was 12.4% (95% CI, 10.9-13.8%) for sepsis and 11.0% (95% CI, 9.7-12.2%) for severe sepsis including septic shock. The ICU and hospital mortality of patients with severe sepsis was 48.4 and 55.2%, respectively, without significant differences between hospital size. Prevalence and mean length of ICU stay of patients with severe sepsis were significantly higher in larger hospitals and universities (</= 200 beds: 6% and 11.5 days, universities: 19% and 19.2 days, respectively).
  
  
  CONCLUSIONS
  The expected number of newly diagnosed cases with severe sepsis in Germany amounts to 76-110 per 100,000 adult inhabitants. To allow better comparison between countries, future epidemiological studies should use standardized study methodologies with respect to sepsis definitions, hospital size, and daily and monthly variability.
authors.affiliation: Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Haertelstrasse 16-18, 04107, Leipzig, Germany. engel@imise.uni-leipzig.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Engel
authors.forename: Frank M
authors.initials: FM
authors.lastname: Brunkhorst
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Bone
authors.forename: Reinhard
authors.initials: R
authors.lastname: Brunkhorst
authors.forename: Herwig
authors.initials: H
authors.lastname: Gerlach
authors.forename: Stefan
authors.initials: S
authors.lastname: Grond
authors.forename: Matthias
authors.initials: M
authors.lastname: Gruendling
authors.forename: Guenter
authors.initials: G
authors.lastname: Huhle
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jaschinski
authors.forename: Stefan
authors.initials: S
authors.lastname: John
authors.forename: Konstantin
authors.initials: K
authors.lastname: Mayer
authors.forename: Michael
authors.initials: M
authors.lastname: Oppert
authors.forename: Derk
authors.initials: D
authors.lastname: Olthoff
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.forename: Max
authors.initials: M
authors.lastname: Ragaller
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.forename: Frank
authors.initials: F
authors.lastname: Stuber
authors.forename: Norbert
authors.initials: N
authors.lastname: Weiler
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
authors.forename: Holger
authors.initials: H
authors.lastname: Bogatsch
authors.forename: Christiane
authors.initials: C
authors.lastname: Hartog
authors.forename: Markus
authors.initials: M
authors.lastname: Loeffler
authors.forename: Konrad
authors.initials: K
authors.lastname: Reinhart
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018805:Sepsis / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D012720:Severity of Illness Index