title: Epidemiologic trend of severe sepsis in Taiwan from 1997 through 2006.
abstract: BACKGROUND
  The epidemiologic data of severe sepsis are limited in developing countries. Among patients, the contribution of subsequent severe sepsis episodes to the disease burden is unclear.
  
  
  METHODS
  We analyzed the hospitalization claims data of a nationally representative sample of 200,000 people, approximately 1% of the population, enrolled in the Taiwan National Health Insurance program. We identified first and subsequent episodes of severe sepsis hospital admissions from 1997 to 2006 based on International Classification of Diseases, 9th ed., Clinical Modification codes for infections and acute organ dysfunction.
  
  
  RESULTS
  During the 10-year period, we identified 5,258 patients having 7,531 hospitalizations for severe sepsis in the study cohort. The age-standardized annual incidence rates of first episodes increased by 1.6-fold from 135 per 100,000 in 1997 to 217 per 100,000 in 2006, with an annual percent change of 3.9% (95% CI, 2.3%-5.5%). Although the proportion of patients with multiorgan (>or= 2) dysfunctions increased from 11.7% in 1997 to 27.6% in 2006, the hospital mortality changed little, averaging 30.8%. Among survivors, 34.4% developed at least one subsequent severe sepsis episode, which contributed 30.2% to the disease burden in 10 years.
  
  
  CONCLUSIONS
  The incidence and disease severity of severe sepsis in Taiwan are increasing. One-third of the survivors developed at least one subsequent episode, which contributed substantially to the disease burden over time.
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, Yong Kang City, Tainan, Taiwan.
authors.forename: Hsiu-Nien
authors.initials: HN
authors.lastname: Shen
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.forename: Hsi-Hsing
authors.initials: HH
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D018805:Sepsis / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology