Epidemiological and Clinical Characteristics of Community-Acquired Severe Sepsis and Septic Shock: A Prospective Observational Study in 12 University Hospitals in Korea

• Published in: Journal of Korean medical science Vol. 27; no. 11; pp. 1308 - 1314
• Main Authors: Park, Dae Won, Chun, Byung Chul, Kim, June Myung, Sohn, Jang Wook, Peck, Kyong Ran, Kim, Yang Soo, Choi, Young Hwa, Choi, Jun Yong, Kim, Sang Il, Eom, Joong Sik, Kim, Hyo Youl, Song, Joon Young, Song, Young Goo, Choi, Hee Jung, Kim, Min Ja
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.11.2012; 대한의학회
• Subjects: Adult; Aged; Aged, 80 and over; APACHE; Bacteremia - epidemiology; Bacteremia - microbiology; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Community-Acquired Infections - virology; Comorbidity; Female; Hospital Mortality; Hospitals, University; Humans; Intensive Care Units; Logistic Models; Lung Diseases - epidemiology; Male; Metabolic Diseases - epidemiology; Middle Aged; Neoplasms - epidemiology; Odds Ratio; Original; Prospective Studies; Republic of Korea; Risk Factors; Sepsis - diagnosis; Sepsis - epidemiology; Sepsis - mortality; Severity of Illness Index; Sex Factors; Shock, Septic - diagnosis; Shock, Septic - epidemiology; Shock, Septic - mortality; Urinary Tract Infections - epidemiology; 의학일반; Republic of Korea; Severe Sepsis; Septic Shock; Gender; Risk Factor; Epidemiology; Mortality
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2012.27.11.1308

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.