Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China.
OBJECTIVE
To determine the occurrence rate, outcomes, and the characteristics of severe sepsis in surgical intensive care units in multiple medical centers within China and to assess the cost and resource use of severe sepsis in China.


METHODS
Prospective, observational study of surgical intensive care unit patients at ten university hospitals in six provinces in China.


METHODS
All adult admissions in studied intensive care units from December 1, 2004, to November 30, 2005.


METHODS
None.


RESULTS
The criteria of severe sepsis were based on the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definition. Analysis of data from 3,665 intensive care unit admissions identified 318 (8.68%) cases of severe sepsis, 64.8% of which were men. The median age (interquartile range) of patients with severe sepsis was 64 (47-74) yrs. Microbes had been isolated from 228 (71.7%) patients, including 171 (53.8%) with Gram-negative bacteria and 146 (45.9%) with Gram-positive bacteria. A total of 90 (22.0%) patients had invasive fungal infection, 20 (6.3%) of which had fungemia. The abdomen was the most common site of infections (72.3%), followed by lung (52.8%). The overall hospital mortality of severe sepsis was 48.7%. Risk factors for hospital mortality included age, chronic comorbidity of malignant neoplasm, Gram-positive bacterial infection, invasive fungal infection, admission Acute Physiology Score, and admission Sequential Organ Failure Assessment score of respiratory dysfunction and cardiovascular dysfunction. The median Therapeutic Intervention Scoring System-28 score was 43 (38-49). The mean hospital cost was $11,390 per patient and $502 per patient per day.


CONCLUSIONS
Severe sepsis is a common, expensive, and frequently fatal syndrome in critically ill surgical patients in China. Other than the microbiological patterns, the incidence, mortality, and major characteristics of severe sepsis in Chinese surgical intensive care units are close to those documented in developed countries.
Cheng
Baoli
B
Department of Anesthesiology, Intensive Care Unit, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Xie
Guohao
G
Yao
ShangLong
S
Wu
Xinmin
X
Guo
Qulian
Q
Gu
Miaoning
M
Fang
Qiang
Q
Xu
Qiuping
Q
Wang
Dongxin
D
Jin
Yuhong
Y
Yuan
ShiYing
S
Wang
Junlu
J
Du
Zhaohui
Z
Sun
Yunbo
Y
Fang
XiangMing
X
D000328:Adult; D000368:Aged; D002681:China; D016638:Critical Illness; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology*; D012720:Severity of Illness Index