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KMID : 1144420190340030179
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Acute and Critical Care
2019 Volume.34 No. 3 p.179 ~ p.191
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Characteristics, management and clinical outcomes of patients with sepsis: a multicenter cohort study in Korea
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Jeon Kyeong-Man
Na Soo-Jin
Oh Dong-Kyu
Park Sung-Hoon
Choi Eun-Young
Kim Seok-Chan
Seong Gil-Myeong
Heo Jeong-Won
Chang You-Jin
Kwack Won-Gun
Kang Byung-Ju
Choi Won-Il
Kim Kyung-Chan
Park So-Young
Kwak Sang-Hyun
Shin Yoon-Mi
Lee Heung-Bum
Park So-Hee
Cho Jae-Hwa
Kim Beong-Ki
Lim Chae?Man
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Abstract
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Background: Mortality rates associated with sepsis have increased progressively in Korea, but domestic epidemiologic data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods: This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals during a 1-month period were screened for eligibility. Among these, patients diagnosed with sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in the study.
Results: Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5% presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%, P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to home and 38.6% were transferred to other hospitals or facilities.
Conclusions: This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high mortality and were often referred to step-down centers after acute and critical care.
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KEYWORD
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epidemiology, Korea, mortality, prevalence, sepsis, septic shock
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