Epidemiology Of Severe Sepsis In Critical Ⅲ Patients In 10 University Hospitals In China: A Multi-center Nationwide Study

ObjectivesTo determine the period incidence and outcomes of severe sepsis in intensive care units (ICUs) in multiple medical centers; to characterize differences in demographics and infection; and to assess the cost and resource use of severe sepsis in China.Design and SettingProspective, observational study of surgical ICU patients at 10 university hospitals in 6 provinces in China. All adult admissions in studied ICUs from December 1st, 2004 to November 30th, 2005.Measurements and Main ResultsAnalysis of data derived from 3665 ICU admissions over a 1-year period identified 318 (8.68%) cases of severe sepsis, 64.8% of which were males. The median age of severe sepsis patients was 64 (47-74) yrs. A total of 228(71.7%) patients had isolated microbes, including 171 patients (53.8%) with gram-negative bacteria and 146 patients (45.9%) with gram-positive bacteria. Ninety (22.0%) patients suffered from invasive fungal infection, 20 (6.3%) of which had fungemia. The abdomen was the most common site of infections (72.3%), followed by the lung (52.8%). The overall hospital mortality of severe sepsis was 48.7%. Risk factors for hospital mortality included age, chronic comorbidity of malignancy, gram-positive bacteria infection, invasive fungal infection, APS, admission SOFA score of respiratory dysfunction and cardiovascular dysfunction. The median TISS score was 43 (38-49) and the mean hospital cost was $ 11,390 per patient and $ 502 per patient per day.ConclusionsThis multi-center study showed that severe sepsis is also a common, expensive, and frequently fatal syndrome in critical ill patients in China.