title: Epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock: a prospective observational study in 12 university hospitals in Korea.
abstract: A prospective multicenter observational study was performed to investigate the epidemiology and outcomes of community-acquired severe sepsis and septic shock. Subjects included 1,192 adult patients admitted to the 22 participating intensive care units (ICUs) of 12 university hospitals in the Korean Sepsis Registry System from April, 2005 through February, 2009. Male accounted for 656 (55%) patients. Mean age was 65.0 ± 14.2 yr. Septic shock developed in 740 (62.1%) patients. Bacteremia was present in 422 (35.4%) patients. The 28-day and in-hospital mortality rates were 23.0% and 28.0%, respectively. Men were more likely to have comorbid illnesses and acute organ dysfunctions, and had higher mortality and clinical severity compared to women. While respiratory sources of sepsis were common in men, urinary sources were predominant in women. In the multivariate logistic regression analysis, cancer (odds ratio 1.89; 95% confidence interval 1.13-3.17), urinary tract infection (0.25; 0.13-0.46), APACHE II score (1.05; 1.02-1.09), SOFA score on day 1 (1.13; 1.06-1.21) and metabolic dysfunction (2.24, 1.45-3.45) were independent clinical factors for gender-related in-hospital mortality. This study provided epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock in ICUs in Korea, and demonstrated the impact of clinical factors on gender difference in mortality.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Park
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Chun
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
authors.forename: Jang Wook
authors.initials: JW
authors.lastname: Sohn
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Young Hwa
authors.initials: YH
authors.lastname: Choi
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Joong Sik
authors.initials: JS
authors.lastname: Eom
authors.forename: Hyo Youl
authors.initials: HY
authors.lastname: Kim
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Song
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Choi
authors.forename: Min Ja
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012720:Severity of Illness Index; D012737:Sex Factors; D012772:Shock, Septic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D014552:Urinary Tract Infections / Q000453:epidemiology