Different patient case mix by applying the 2003 SCCM/ESICM/ACCP/ATS/SIS sepsis definitions instead of the 1992 ACCP/SCCM sepsis definitions in surgical patients: a retrospective observational study

Autor: Karl Traeger, Martina Kron, Juergen Altherr, Marion Schneider, Markus Huber-Lang, Birgit Hay, Manfred Weiss, Michael Taenzer
Rok vydání: 2009
Předmět:
Male
Consensus Development Conferences as Topic
Postoperative Complications
Cause of Death
Germany
Hospital Mortality
Young adult
Child
Societies
Medical
Aged
80 and over
education.field_of_study
Health Policy
Mortality rate
Middle Aged
Shock
Septic
Systemic Inflammatory Response Syndrome
Computer Science Applications
Intensive Care Units
Child
Preschool
lcsh:R858-859.7
Female
Research Article
Adult
medicine.medical_specialty
Adolescent
Multiple Organ Failure
Population
Health Informatics
lcsh:Computer applications to medicine. Medical informatics
Sepsis
Young Adult
Case mix index
Terminology as Topic
medicine
Humans
Intensive care medicine
education
Diagnosis-Related Groups
Aged
Retrospective Studies
business.industry
Septic shock
Infant
Retrospective cohort study
medicine.disease
United States
Systemic inflammatory response syndrome
Cross-Sectional Studies
Wounds and Injuries
business
Zdroj: BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, Vol 9, Iss 1, p 25 (2009)
ISSN: 1472-6947
DOI: 10.1186/1472-6947-9-25
Popis: Background Revised consensus sepsis definitions have been published in 2003. The present study was performed to compare the prevalence of different stages of sepsis and ICU mortality rates and find out the case mix within the same collective of postoperative/posttraumatic patients applying either the original 1992 ACCP/SCCM or the revised 2003 SCCM/ESICM/ACCP/ATS/SIS sepsis definitions. Methods Retrospective observational single-centre study in surgical critically ill patients admitted to an University adult ICU. From 01/2007 to 12/2007, 742 patients were surveyed daily computer-assisted with respect to different stages of sepsis. Results Within the same patient collective, applying the 2003 definitions instead of the 1992 definitions, prevalence of severe sepsis (61 vs. 56) and septic shock (205 vs. 162) was higher (p < 0.001). In patients with septic shock according to the 2003 definitions, mortality rate of 22% was lower than that of 27%, when the 1992 definitions were used. Risk of death was increased for those patients classified to be in septic shock with any of the definitions (OR 6.5, p = 0.001). Sensitivity to predict deaths was slightly higher with the 2003 definitions (92%) than with the 1992 definitions (88%), and specificity was lower (31% vs. 49%). Conclusion The prevalence and mortality rates of various sepsis severity stages differ if defined by the 1992 or the 2003 definitions. Thus, transferring conclusions drawn from data sets regarding severity of sepsis generated with the 1992 definitions to the same population applying the 2003 definitions may be misleading. The 1992 definitions may under-classify patients with severe sepsis.
Databáze: OpenAIRE
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