Temporal trends in patient characteristics and survival of intensive care admissions with sepsis: a multicenter analysis*.
OBJECTIVE
To estimate in-hospital, 1-yr, and long-term mortality and to assess time trends in incidence and outcomes of sepsis admissions in the intensive care unit.


METHODS
A population-based, multicenter, retrospective cohort study.


METHODS
Patients hospitalized with sepsis in the intensive care unit in seven general hospitals in Israel during 2002-2008.


METHODS
None.


METHODS
Survival data were collected and analyzed according to demographic and background clinical characteristics, as well as features of the sepsis episode, using Kaplan-Meier approach for long-term survival.


RESULTS
A total of 5,155 patients were included in the cohort (median age: 70, 56.3% males; median Charlson comorbidity index: 4). The mean number of intensive care unit admissions per month increased over time, while no change in in-hospital mortality was observed. The proportion of patients surviving to hospital discharge was 43.9%. The 1-, 2-, 5-, and 8-yr survival rates were 33.0%, 29.8%, 23.3%, and 19.8%, respectively. Mortality was higher in older patients, patients with a higher Charlson comorbidity index, and those with multiorgan failure, and similar in males and females. One-year age-standardized mortality ratio was 21-fold higher than expected, based on the general population rates.


CONCLUSIONS
Mortality following intensive care unit sepsis admission remains high and is correlated with underlying patients' characteristics, including age, comorbidities, and the number of failing organ systems.
Hospital Division, Clalit Health Services, Tel Aviv, Israel.
Jacob
J
Dreiher
Yaniv
Y
Almog
Charles L
CL
Sprung
Shlomi
S
Codish
Moti
M
Klein
Sharon
S
Einav
Yaron
Y
Bar-Lavie
Pierre P
PP
Singer
Adi
A
Nimrod
Jeffrey
J
Sachs
Daniel
D
Talmor
Michael
M
Friger
Dan
D
Greenberg
David
D
Olsfanger
Moshe
M
Hersch
Victor
V
Novack
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult