title: Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China.
abstract: BACKGROUND
  Information about sepsis in mainland China remains scarce and incomplete. The purpose of this study was to describe the epidemiology and outcome of severe sepsis and septic shock in mixed ICU in mainland China, as well as the independent predictors of mortality.
  
  
  METHODS
  We performed a 2-month prospective, observational cohort study in 22 closed multi-disciplinary intensive care units (ICUs). All admissions into those ICUs during the study period were screened and patients with severe sepsis or septic shock were included.
  
  
  RESULTS
  A total of 484 patients, 37.3 per 100 ICU admissions were diagnosed with severe sepsis (n = 365) or septic shock (n = 119) according to clinical criteria and included into this study. The most frequent sites of infection were the lung and abdomen. The overall ICU and hospital mortality rates were 28.7% (n = 139) and 33.5% (n = 162), respectively. In multivariate analyses, APACHE II score (odds ratio[OR], 1.068; 95% confidential interval[CI], 1.027-1.109), presence of ARDS (OR, 2.676; 95%CI, 1.691-4.235), bloodstream infection (OR, 2.520; 95%CI, 1.142-5.564) and comorbidity of cancer (OR, 2.246; 95%CI, 1.141-4.420) were significantly associated with mortality.
  
  
  CONCLUSIONS
  Our results indicated that severe sepsis and septic shock were common complications in ICU patients and with high mortality in China, and can be of help to know more about severe sepsis and septic shock in China and to improve characterization and risk stratification in these patients.
authors.affiliation: Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Emergency Medicine and Medical ICU, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Chuanyun
authors.initials: C
authors.lastname: Qian
authors.affiliation: Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Mingyan
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, Urumqi, China.
authors.forename: Xiangyou
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Yuhang
authors.initials: Y
authors.lastname: Ai
authors.affiliation: Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Critical Care Medicine, The Second Hospital of Jilin University, Changchun, China.
authors.forename: Dexin
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, Peking University People's Hospital, Beijing, China.
authors.forename: Youzhong
authors.initials: Y
authors.lastname: An
authors.affiliation: Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Renhua
authors.initials: R
authors.lastname: Sun
authors.affiliation: Department of Critical Care Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
authors.forename: Shusheng
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, Shijiazhuang, China.
authors.forename: Zhenjie
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, China.
authors.forename: Xiangyuan
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Emergency and Intensive Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Fachun
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Lin
authors.affiliation: Emergency ICU, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Enqiang
authors.initials: E
authors.lastname: Mao
authors.affiliation: Department of Critical Care Medicine, Guangdong General Hospital, Guangzhou, China.
authors.forename: Tiehe
authors.initials: T
authors.lastname: Qin
authors.affiliation: Department of Critical Care Medicine, Hainan Provincial People's Hospital, Haikou, China.
authors.forename: Zhenyang
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Critical Care Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Du
mesh_terms: D002681:China; D015331:Cohort Studies; D003428:Cross Infection; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D012772:Shock, Septic / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality