3차 대학병원 내과계 중환자실 내 중증 패혈증의 유병률과 예후인자
The Characteristics and Prognostic Factors of Severe Sepsis in Patients Who Were Admitted to a Medical Intensive Care Unit of a Tertiary Hospital
2
조회
0
다운로드
10
인용
0
참고문헌
키워드
초록
Background: Severe sepsis is a major cause of morbidity and mortality in intensive care units. This study aimed to evaluate the prevalence, characteristics, outcomes and prognostic factors of severe sepsis in a medical intensive care unit (MICU) of a tertiary care hospital in Korea. Methods: We retrospectively reviewed the medical chart of 249 patients who were admitted to a medical intensive care unit with severe sepsis. Results: From January 2000 to December 2001, 3410 patients were admitted to the ICU. The prevalence of severe sepsis was 7.3%. The mortality of severe sepsis was 64.6%. The prognostic factors for severe sepsis were the number of organ systems that acutely failed (p=0.036) and an admission route from general wards (p=0.018). There was no difference in the outcome of severe sepsis according to infectious organisms (p=0.24) and the site of infections (p=0.38). Conclusions: Severe sepsis in the MICU is a common, expensive and often fatal condition. We expect that early rescucitation and recovery from acute organ system failure will improve the outcome of severe sepsis.
Abstract
Background: Severe sepsis is a major cause of morbidity and mortality in intensive care units. This study aimed to evaluate the prevalence, characteristics, outcomes and prognostic factors of severe sepsis in a medical intensive care unit (MICU) of a tertiary care hospital in Korea. Methods: We retrospectively reviewed the medical chart of 249 patients who were admitted to a medical intensive care unit with severe sepsis. Results: From January 2000 to December 2001, 3410 patients were admitted to the ICU. The prevalence of severe sepsis was 7.3%. The mortality of severe sepsis was 64.6%. The prognostic factors for severe sepsis were the number of organ systems that acutely failed (p=0.036) and an admission route from general wards (p=0.018). There was no difference in the outcome of severe sepsis according to infectious organisms (p=0.24) and the site of infections (p=0.38). Conclusions: Severe sepsis in the MICU is a common, expensive and often fatal condition. We expect that early rescucitation and recovery from acute organ system failure will improve the outcome of severe sepsis.
참고문헌 (22)
- Sands KE, "Epidemiology of sepsis syndrome in 8 academic medical centers", JAMA, 278, pp.234~240 (1997)
- Brun-Buisson C, "Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units", JAMA, 274, pp.968~974 (1995), French ICU Group for Severe Sepsis
- Kieft H, "The sepsis syndrome in a Dutch university hospital. Clinical obsevations", Arch Intern Med, 153, pp.2241~2247 (1993)
- Angus DC, "Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care", Crit Care Med, 29, pp.1303~1310 (2001)
- Angus DC, "Epidemiology of sepsis: an update", Crit Care Med, 29, pp.S109~S116 (2001)
- Short TG, "Long-term outcome and functional health status following intensive care in Hong Kong", Crit Care Med, 27, pp.51~57 (1999)
- Salvo I, "The Italian SEPSIS study: preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock", Intensive Care Med, 21, pp.S244~S249 (1995)
- Bernard GR, "Efficacy and safety of recombinant human activated protein C for severe sepsis", N Eng J Med, 344, pp.699~709 (2001)
- Wheeler AP, "Treating patients with severe sepsis", N Eng J Med, 340, pp.207~214 (1999)
- Rivers E, "Early goal-directed therapy in the treatment of severe sepsis and septic shock", N Engl J Med, 345, pp.1368~1377 (2001)
- Berghe GV, "Intensive insulin therapy in critically ill patients", N Engl J Med, 345, pp.1359~1366 (2001)
- Knaus WA, "Evaluation of definitions for sepsis", Chest, 101, pp.1656~1662 (1992)
- Bone RC, "Definitions or sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP", SCCM Consensus conference Committee, 1992, pp.101, 1644~1655[DOI]
- Levy MM, "2001 SCCM", ESICM, ATS, pp.SIS International Sepsis Definitions Conference, Crit Care Med[DOI]
- Rangel-Frausto MS, "The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study", JAMA, 273, pp.117~123 (1995)
- Knaus WA, "The APATCHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults", Chest, 100, pp.1619~1636 (1991)
- Knaus WA, "Prognosis in acute organ-system failure", Ann Surg, 202, pp.685~693 (1985)
- Schröder J, "Gender differences in human sepsis", Arch Surg, 133, pp.1200~1205 (1998)
- Wichmann MX, "Incidence and mortality of severe sepsis in surgical intensive care paitents: the influence of patient gender on disease process and outcome", Intensive Care Med, 26, pp.167~172 (2000)
- Crabtree TD, "Gender-dependent differences in outcome after the treatment of infection in hospitalized patients", JAMA, 282, pp.2143~2148 (1999)
- Opal SM, "Clinical Gram-positive sepsis: does it fundamentally differ from gram-negative bacterial sepsis?", Crit care Med, 27, pp.1608~1616 (1999)
- Fariñas-Alvarez C, "Epidemiological difference between sepsis syndrome with bacteremia and culture-negative sepsis", Infect Control Hosp Epidemiol, 21, pp.639~644 (2000)