Epidemiology of sepsis in Norway in 1999

Abstract

Introduction: Sepsis and severe sepsis are associated with high hospital mortality. Little is known about the occurrence of sepsis in general hospital populations. The goal of the present study was to reveal the epidemiology of sepsis in Norwegian hospitals over 1 year.

Methods: Patients admitted to all Norwegian hospitals during 1999 (n = 700,107) were analyzed by searching the database of the Norwegian Patient Registry for markers of sepsis, using International Classification of Diseases (ICD)-10 codes for sepsis and severe infections. In patients with such diagnoses, demographic data, hospital outcome data and ICD-10 codes for organ dysfunction were also retrieved. Sepsis was further classified as primary or secondary, and severe (sepsis with vital organ dysfunction) or nonsevere. The age-adjusted mortality rate, and the sepsis rates for all hospital admissions and in the Norwegian population were calculated.

Results: A total of 6665 patients were classified as having sepsis, and of these 2121 (31.8%) had severe sepsis. The most frequent failing organ system was the circulatory system, and 1562 had septic shock. Mortality increased from 7.1% (in those with no documented organ dysfunction) to 71.8% (in those with three or more organ dysfunctions). The mean mortality was 13.5%, and the mortality of severe sepsis was 27%. The incidence of sepsis was 9.5/1000 hospital admissions and 1.49/1000 inhabitants in 1999.

Conclusion: Sepsis is not uncommon in Norwegian hospitals and is associated with high hospital mortality, which is similar to recent findings from the USA. Awareness of sepsis and its appropriate treatment is mandatory in Norway if we are to reduce mortality from sepsis by 25% in the next 5 years.

Figure 1

Association between organ failure and mortality.

Figure 2

Incidence of mortality from sepsis in different age groups: Norway 1999

Figure 3

Bacteriological identity of infecting agents when coded for (n = 2020)