The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand.

Sandra L Peake, Rinaldo Bellomo, Peter A Cameron, Anthony Cross, Anthony Delaney, Simon Finfer, Carol P George, Alisa Higgins, Daryl Andrew Jones, John L Moran, John A Myburgh, Gillian Ann Syres, Steven Robert Webb, Patricia Williams

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Abstract

Background: Early goal-directed therapy might benefit patients with sepsis and septic shock in Australia and New Zealand. However, the current treatment and outcome of these patients is unknown. Objective: To report the characteristics and outcome of patients with sepsis and septic shock presenting to hospital emergency departments (EDs) in Australia and New Zealand. Setting: All Australian and New Zealand intensive care units contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), 1997-2005. Methods: Patients with an ICU admission diagnosis of nonurinary or urinary sepsis, or non-urinary or urinary sepsis with shock admitted from EDs between 1 January 1997 and 31 December 2005 were identified from the ANZICS APD. Predictor variables for hospital mortality were analysed using logistic regression. Results: 7649 patients were admitted during the study period. The number of patients admitted per year increased progressively (1997, n= 368 [7.7 admissions per ICU]; 2005, n = 1409 [14.0 admissions per ICU]). Non-urinary sepsis with shock (n =3394, 44.4 ) was the commonest admission diagnosis, and urinary sepsis with shock the least common (n = 607, 7.9 ). Overall ICU and hospital mortality were 20.9 (n=1513/7250) and 27.6 (n=1980/7172), respectively. Hospital mortality was predicted by hospital type (tertiary, metropolitan, rural or private), patient age, APACHE III score, sepsis classification, mechanical ventilation within the first 24 hours after ICU admission, and calendar year. A significant interaction between sepsis classification and calendar year was demonstrated, with a linear decrease in mortality over time (odds ratio, 0.92; 95 CI, 0.86-0.99; P=0.02). Conclusions: The reported incidence of sepsis and septic shock in ICU patients presenting to the ED appears to have increased since 1997. In contrast, hospital mortality has decreased. These data require confirmation with a prospective cohort study.
Original languageEnglish
Pages (from-to)8 - 18
Number of pages11
JournalCritical Care and Resuscitation
Volume9
Issue number1
Publication statusPublished - 2007

Cite this

@article{67f80d07bf81462dbbd4f0c8de830a8a,
title = "The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand.",
abstract = "Background: Early goal-directed therapy might benefit patients with sepsis and septic shock in Australia and New Zealand. However, the current treatment and outcome of these patients is unknown. Objective: To report the characteristics and outcome of patients with sepsis and septic shock presenting to hospital emergency departments (EDs) in Australia and New Zealand. Setting: All Australian and New Zealand intensive care units contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), 1997-2005. Methods: Patients with an ICU admission diagnosis of nonurinary or urinary sepsis, or non-urinary or urinary sepsis with shock admitted from EDs between 1 January 1997 and 31 December 2005 were identified from the ANZICS APD. Predictor variables for hospital mortality were analysed using logistic regression. Results: 7649 patients were admitted during the study period. The number of patients admitted per year increased progressively (1997, n= 368 [7.7 admissions per ICU]; 2005, n = 1409 [14.0 admissions per ICU]). Non-urinary sepsis with shock (n =3394, 44.4 ) was the commonest admission diagnosis, and urinary sepsis with shock the least common (n = 607, 7.9 ). Overall ICU and hospital mortality were 20.9 (n=1513/7250) and 27.6 (n=1980/7172), respectively. Hospital mortality was predicted by hospital type (tertiary, metropolitan, rural or private), patient age, APACHE III score, sepsis classification, mechanical ventilation within the first 24 hours after ICU admission, and calendar year. A significant interaction between sepsis classification and calendar year was demonstrated, with a linear decrease in mortality over time (odds ratio, 0.92; 95 CI, 0.86-0.99; P=0.02). Conclusions: The reported incidence of sepsis and septic shock in ICU patients presenting to the ED appears to have increased since 1997. In contrast, hospital mortality has decreased. These data require confirmation with a prospective cohort study.",
author = "Peake, {Sandra L} and Rinaldo Bellomo and Cameron, {Peter A} and Anthony Cross and Anthony Delaney and Simon Finfer and George, {Carol P} and Alisa Higgins and Jones, {Daryl Andrew} and Moran, {John L} and Myburgh, {John A} and Syres, {Gillian Ann} and Webb, {Steven Robert} and Patricia Williams",
year = "2007",
language = "English",
volume = "9",
pages = "8 -- 18",
journal = "Critical Care and Resuscitation",
issn = "1441-2772",
publisher = "Australasian Medical Publishing Co. Pty Ltd. (AMPCo)",
number = "1",

}

The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand. / Peake, Sandra L; Bellomo, Rinaldo; Cameron, Peter A; Cross, Anthony; Delaney, Anthony; Finfer, Simon; George, Carol P; Higgins, Alisa; Jones, Daryl Andrew; Moran, John L; Myburgh, John A; Syres, Gillian Ann; Webb, Steven Robert; Williams, Patricia.

In: Critical Care and Resuscitation, Vol. 9, No. 1, 2007, p. 8 - 18.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The outcome of patients with sepsis and septic shock presenting to emergency departments in Australia and New Zealand.

AU - Peake, Sandra L

AU - Bellomo, Rinaldo

AU - Cameron, Peter A

AU - Cross, Anthony

AU - Delaney, Anthony

AU - Finfer, Simon

AU - George, Carol P

AU - Higgins, Alisa

AU - Jones, Daryl Andrew

AU - Moran, John L

AU - Myburgh, John A

AU - Syres, Gillian Ann

AU - Webb, Steven Robert

AU - Williams, Patricia

PY - 2007

Y1 - 2007

N2 - Background: Early goal-directed therapy might benefit patients with sepsis and septic shock in Australia and New Zealand. However, the current treatment and outcome of these patients is unknown. Objective: To report the characteristics and outcome of patients with sepsis and septic shock presenting to hospital emergency departments (EDs) in Australia and New Zealand. Setting: All Australian and New Zealand intensive care units contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), 1997-2005. Methods: Patients with an ICU admission diagnosis of nonurinary or urinary sepsis, or non-urinary or urinary sepsis with shock admitted from EDs between 1 January 1997 and 31 December 2005 were identified from the ANZICS APD. Predictor variables for hospital mortality were analysed using logistic regression. Results: 7649 patients were admitted during the study period. The number of patients admitted per year increased progressively (1997, n= 368 [7.7 admissions per ICU]; 2005, n = 1409 [14.0 admissions per ICU]). Non-urinary sepsis with shock (n =3394, 44.4 ) was the commonest admission diagnosis, and urinary sepsis with shock the least common (n = 607, 7.9 ). Overall ICU and hospital mortality were 20.9 (n=1513/7250) and 27.6 (n=1980/7172), respectively. Hospital mortality was predicted by hospital type (tertiary, metropolitan, rural or private), patient age, APACHE III score, sepsis classification, mechanical ventilation within the first 24 hours after ICU admission, and calendar year. A significant interaction between sepsis classification and calendar year was demonstrated, with a linear decrease in mortality over time (odds ratio, 0.92; 95 CI, 0.86-0.99; P=0.02). Conclusions: The reported incidence of sepsis and septic shock in ICU patients presenting to the ED appears to have increased since 1997. In contrast, hospital mortality has decreased. These data require confirmation with a prospective cohort study.

AB - Background: Early goal-directed therapy might benefit patients with sepsis and septic shock in Australia and New Zealand. However, the current treatment and outcome of these patients is unknown. Objective: To report the characteristics and outcome of patients with sepsis and septic shock presenting to hospital emergency departments (EDs) in Australia and New Zealand. Setting: All Australian and New Zealand intensive care units contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), 1997-2005. Methods: Patients with an ICU admission diagnosis of nonurinary or urinary sepsis, or non-urinary or urinary sepsis with shock admitted from EDs between 1 January 1997 and 31 December 2005 were identified from the ANZICS APD. Predictor variables for hospital mortality were analysed using logistic regression. Results: 7649 patients were admitted during the study period. The number of patients admitted per year increased progressively (1997, n= 368 [7.7 admissions per ICU]; 2005, n = 1409 [14.0 admissions per ICU]). Non-urinary sepsis with shock (n =3394, 44.4 ) was the commonest admission diagnosis, and urinary sepsis with shock the least common (n = 607, 7.9 ). Overall ICU and hospital mortality were 20.9 (n=1513/7250) and 27.6 (n=1980/7172), respectively. Hospital mortality was predicted by hospital type (tertiary, metropolitan, rural or private), patient age, APACHE III score, sepsis classification, mechanical ventilation within the first 24 hours after ICU admission, and calendar year. A significant interaction between sepsis classification and calendar year was demonstrated, with a linear decrease in mortality over time (odds ratio, 0.92; 95 CI, 0.86-0.99; P=0.02). Conclusions: The reported incidence of sepsis and septic shock in ICU patients presenting to the ED appears to have increased since 1997. In contrast, hospital mortality has decreased. These data require confirmation with a prospective cohort study.

UR - http://www.anzca.edu.au/jficm/resources/ccr/2007/march/ccr_09_1_0307_008.pdf

M3 - Article

VL - 9

SP - 8

EP - 18

JO - Critical Care and Resuscitation

JF - Critical Care and Resuscitation

SN - 1441-2772

IS - 1

ER -