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Critical Care
Published in: Critical Care 2/2013

Open Access 01-04-2013 | Research

The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study

Authors: Jean-Pierre Quenot, Christine Binquet, Fady Kara, Olivier Martinet, Frederique Ganster, Jean-Christophe Navellou, Vincent Castelain, Damien Barraud, Joel Cousson, Guillaume Louis, Pierre Perez, Khaldoun Kuteifan, Alain Noirot, Julio Badie, Chaouki Mezher, Henry Lessire, Arnaud Pavon

Published in: Critical Care | Issue 2/2013

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Abstract

Introduction

To provide up-to-date information on the prognostic factors associated with 28-day mortality in a cohort of septic shock patients in intensive care units (ICUs).

Methods

Prospective, multicenter, observational cohort study in ICUs from 14 French general (non-academic) and university teaching hospitals. All consecutive patients with septic shock admitted between November 2009 and March 2011 were eligible for inclusion. We prospectively recorded data regarding patient characteristics, infection, severity of illness, life support therapy, and discharge.

Results

Among 10,941 patients admitted to participating ICUs between October 2009 and September 2011, 1,495 (13.7%) patients presented inclusion criteria for septic shock and were included. Invasive mechanical ventilation was needed in 83.9% (n = 1248), inotropes in 27.7% (n = 412), continuous renal replacement therapy in 32.5% (n = 484), and hemodialysis in 19.6% (n = 291). Mortality at 28 days was 42% (n = 625). Variables associated with time to mortality, right-censored at day 28: age (for each additional 10 years) (hazard ratio (HR) = 1.29; 95% confidence interval (CI): 1.20-1.38), immunosuppression (HR = 1.63; 95%CI: 1.37-1.96), Knaus class C/D score versus class A/B score (HR = 1.36; 95%CI:1.14-1.62) and Sepsis-related Organ Failure Assessment (SOFA) score (HR = 1.24 for each additional point; 95%CI: 1.21-1.27). Patients with septic shock and renal/urinary tract infection had a significantly longer time to mortality (HR = 0.56; 95%CI: 0.42-0.75).

Conclusion

Our observational data of consecutive patients from real-life practice confirm that septic shock is common and carries high mortality in general ICU populations. Our results are in contrast with the clinical trial setting, and could be useful for healthcare planning and clinical study design.
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Metadata
Title
The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study
Authors
Jean-Pierre Quenot
Christine Binquet
Fady Kara
Olivier Martinet
Frederique Ganster
Jean-Christophe Navellou
Vincent Castelain
Damien Barraud
Joel Cousson
Guillaume Louis
Pierre Perez
Khaldoun Kuteifan
Alain Noirot
Julio Badie
Chaouki Mezher
Henry Lessire
Arnaud Pavon
Publication date
01-04-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12598

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