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- Title
Effect of Sepsis-3 Definition on the Classification of Patients with Sepsis or Septic Shock in South Korea.
- Authors
Oh, Tak Kyu; Song, In-Ae
- Abstract
Background: Little is known about differences in patient characteristics before and after implementation of the new definition of sepsis (Sepsis-3) and whether the new definition is affecting clinical practice in intensive care units. Objective: To examine and compare the clinicoepidemiologic characteristics of patients with sepsis or septic shock before and after implementation of Sepsis-3. Methods: In this population-based cohort study, a nationwide registration database in South Korea was used to identify patients with sepsis or septic shock. Patients admitted to hospitals from 2012 to 2015 constituted the Sepsis-2 group, and patients admitted from 2017 to 2020 constituted the Sepsis-3 group. Results: The study involved 443 217 patients, of whom 170 660 (38.5%) were in the Sepsis-2 group and 272 557 (61.5%) were in the Sepsis-3 group. The mean (SD) age was 73.3 (14.5) years in the Sepsis-2 group and 75.5 (14.5) years in the Sepsis-3 group. The intensive care unit admission rate was higher in the Sepsis-2 group (34.6%, 59 081 of 170 660) than in the Sepsis-3 group (21.3%, 57 997 of 272 557). Multivariable Cox regression analysis showed that 1-year all-cause mortality was 21% lower in the Sepsis-3 group than in the Sepsis-2 group (hazard ratio, 0.79; 95% CI, 0.78–0.79; P <.001). Conclusions: Implementation of the Sepsis-3 definition was associated with an increased number of patients with sepsis. Other findings suggested that patients in the Sepsis-2 group had more severe illness, with increased 1-year all-cause mortality, compared with those in the Sepsis-3 group.
- Subjects
SOUTH Korea; HUMAN services programs; PATIENTS; HOSPITAL admission &; discharge; SEX distribution; SYMPTOMS; HOSPITAL mortality; AGE distribution; MULTIVARIATE analysis; SEVERITY of illness index; DESCRIPTIVE statistics; SEPTIC shock; LONGITUDINAL method; PRE-tests &; post-tests; INTENSIVE care units; CONFIDENCE intervals; COMPARATIVE studies; DATA analysis software; MEDICAL practice; PROPORTIONAL hazards models; REGRESSION analysis; NOSOLOGY
- Publication
American Journal of Critical Care, 2024, Vol 33, Issue 5, p347
- ISSN
1062-3264
- Publication type
Article
- DOI
10.4037/ajcc2024864