From: Sepsis and septic shock in France: incidences, outcomes and costs of care
Septic shock Implicit definition ICD 10th or CCAM | All | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | Trendsa |
---|---|---|---|---|---|---|---|---|
Cases | 492,902 | 69,466 | 76,350 | 81,107 | 81,886 | 89,934 | 94,159 | |
Incidence per 100.000 (age-standardized) | 135 | 146 | 153 | 152 | 165 | 171 | ↗ | |
Deaths per 100.000 (age-standardized) | 62 | 67 | 69 | 69 | 73 | 75 | ↗ | |
Case fatality (age standardized) | 46 | 45 | 45 | 45 | 44 | 44 | ↘ | |
Hospital stay characteristics | ||||||||
Services of admission | ||||||||
Intensive care unit | 353,190 (71.7) | 50,369 (72.5) | 54,181 (71) | 57,553 (71) | 58,678 (71.7) | 64,696 (71.9) | 67,713 (71.9) | = |
Intermediate care facilities | 151,357 (30.7) | 17,917 (25.8) | 21,415 (28) | 24,475 (30.2) | 26,486 (32.3) | 29,721 (33) | 31,343 (33.3) | ↗ |
Characteristics of the patients | ||||||||
Baseline characteristics | ||||||||
Age in years, median (IQR) | 70 [59; 80] | 70 [58; 79] | 70 [58; 80] | 70 [59; 80] | 70 [59; 80] | 70 [59; 80] | 70 [60; 80] | ↗ |
Gender (female) | 190,941 (38.7) | 27,069 (39) | 29,513 (38.7) | 31,535 (38.9) | 31,811 (38.8) | 34,677 (38.6) | 36,336 (38.6) | = |
Comorbidities | ||||||||
Myocardial infarction | 90,838 (18.4) | 12,922 (18.6) | 13,913 (18.2) | 15,084 (18.6) | 15,111 (18.5) | 16,656 (18.5) | 17,152 (18.2) | = |
Congestive heart failure | 147,098 (29.8) | 19,920 (28.7) | 22,285 (29.2) | 24,281 (29.9) | 24,767 (30.2) | 27,548 (30.6) | 28,297 (30.1) | ↗ |
Dementia | 21,630 (4.4) | 3090 (4.4) | 3466 (4.5) | 3631 (4.5) | 3541 (4.3) | 3911 (4.3) | 3991 (4.2) | = |
Chronic pulmonary disease | 80,759 (16.4) | 10,835 (15.6) | 12,109 (15.9) | 13,237 (16.3) | 13,073 (16) | 15,206 (16.9) | 16,299 (17.3) | ↗ |
Diabetes without chronic complication | 81,220 (16.5) | 11,171 (16.1) | 11,832 (15.5) | 13,319 (16.4) | 13,739 (16.8) | 15,467 (17.2) | 15,692 (16.7) | ↗ |
Diabetes with chronic complications | 46,219 (9.4) | 6735 (9.7) | 7175 (9.4) | 7762 (9.6) | 7490 (9.1) | 8519 (9.5) | 8538 (9.1) | ↘ |
Renal disease | 61,383 (12.5) | 7610 (11) | 8875 (11.6) | 10,003 (12.3) | 10,266 (12.5) | 12,231 (13.6) | 12,398 (13.2) | ↗ |
Any malignancy | 111,501 (22.6) | 15,377 (22.1) | 17,038 (22.3) | 18,309 (22.6) | 18,709 (22.8) | 20,778 (23.1) | 21,290 (22.6) | ↗ |
Moderate or severe liver disease | 36,692 (7.4) | 5306 (7.6) | 5706 (7.5) | 6115 (7.5) | 6187 (7.6) | 6559 (7.3) | 6819 (7.2) | ↘ |
Metastatic solid tumor | 37,339 (7.6) | 4734 (6.8) | 5516 (7.2) | 6033 (7.4) | 6311 (7.7) | 7271 (8.1) | 7474 (7.9) | ↗ |
Charlson score, median (IQR) | 2 [1; 4] | 2 [1; 4] | 2 [1; 4] | 2 [1; 4] | 2 [1; 4] | 2 [1; 4] | 2 [1; 4] | ↗ |
Illness severity | ||||||||
Neurological organ failure | 132,587 (26.9) | 16,159 (23.3) | 19,360 (25.4) | 21,817 (26.9) | 22,332 (27.3) | 25,054 (27.9) | 27,865 (29.6) | ↗ |
Renal organ failure | 214,785 (43.6) | 29,032 (41.8) | 32,334 (42.3) | 34,910 (43) | 36,481 (44.6) | 39,981 (44.5) | 42,047 (44.7) | ↗ |
Respiratory organ failure | 227,706 (46.2) | 32,439 (46.7) | 35,664 (46.7) | 37,638 (46.4) | 38,094 (46.5) | 40,982 (45.6) | 42,889 (45.5) | ↘ |
Number of organ failure, median (IQR) | 4 [3; 5] | 4 [3; 5] | 4 [3; 5] | 4 [3; 5] | 4 [3; 5] | 4 [3; 5] | 4 [3; 5] | = |
SAPS II score, median (IQR) (miss = 83,156) | 51 [38; 67] | 51 [38; 67] | 51 [38; 67] | 51 [38; 67] | 51 [38; 67] | 51 [38; 67] | 51 [38; 68] | ↗ |
Outcomes | ||||||||
Hospital LOS (days) (median [IQR]) | 20 [8; 39] | 20 [8; 40] | 20 [8; 39] | 20 [8; 39] | 20 [8; 39] | 19 [8; 38] | 19 [8; 37] | ↘ |
ICU LOS (days) (median [IQR]) (missing = 133,828) | 8 [3; 18] | 9 [3; 20] | 9 [3; 19] | 8 [3; 19] | 8 [3; 18] | 8 [3; 18] | 8 [3; 17] | ↘ |
Discharge to home | 199,613 (40.5) | 27,067 (39) | 30,521 (40) | 32,755 (40.4) | 32,810 (40.1) | 37,433 (41.6) | 39,027 (41.4) | ↗ |
Hospital mortality | 222,709 (45.2) | 32,091 (46.2) | 34,967 (45.8) | 37,007 (45.6) | 37,146 (45.4) | 39,872 (44.3) | 41,626 (44.2) | ↘ |
Cost (€), median (IQR) | 16,449 [7336; 29360] | 17,261.7 [7604; 30765] | 16,129.2 [6918; 29647] | 15,886 [6889; 29107] | 16,538.6 [7387; 29489] | 16,640.1 [7560; 29172] | 16,364.6 [7509; 28504] | ↘ |