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KMID : 1144420190340010030
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Acute and Critical Care
2019 Volume.34 No. 1 p.30 ~ p.37
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Application of Sepsis-3 Criteria to Korean Patients with Critical Illnesses
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Kim Jae-Yeol
Kim Hwan-Il
Suh Gee-Young
Yoon Sang-Won
Kim Tae-Yop
Lee Sang-Haak
Moon Jae-Young
Kwon Jae-Young
Na Sung-Won
Ryu Ho-Geol
Park Ji-Sook
Koh Youn-Suck
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Abstract
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Background: The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based approach, East Asian descents comprised minor portions of the project population.
Methods: We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria using the selected data.
Results: Korean participants of the FACE study were 913 (383 with sepsis and 530 without sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis, sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were 26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality.
Conclusions: The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting ICU and 28-day mortality in Korean ICU patients.
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KEYWORD
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intensive care units, organ dysfunction, Sepsis, Sepsis-3, septic shock
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