Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Nov;11(6):298-303.
doi: 10.1007/BF02898020.

Incidence and outcome of sepsis in Japanese intensive care units: The Japanese nosocomial infection surveillance system

Machi Suka  1 , Katsumi Yoshida, Jun Takezawa
Affiliations

Incidence and outcome of sepsis in Japanese intensive care units: The Japanese nosocomial infection surveillance system

Machi Suka et al. Environ Health Prev Med. 2006 Nov.

Abstract

Objectives: To determine the incidence of sepsis in Japanese intensive care units (ICUs) and to evaluate the impact of sepsis on mortality and length of stay (LOS).

Methods: Using the JANIS database for the period between June 2002 and June 2004, 21,895 eligible patients aged ≥16 years, hospitalized in 28 participating ICUs for ≥24 hours, were monitored until ICU discharge. Adjusted hazard ratio (HR) with 95% confidence interval (CI) for the incidence of sepsis was calculated using Cox's proportional hazard model. Standardized mortality ratio (SMR) was calculated on the basis of the crude mortality in patients without nosocomial infection (NI) for respective APACHE II categories. Mean LOS for survivors was assessed by two-way analysis of variance with adjustment for APACHE II.

Results: Sepsis was diagnosed in 450 patients (2.1%), with 228 meeting the definition on ICU admission and 222 during the ICU stay. The overall incidence of sepsis was 1.02/100 admissions or 2.00/1000 patient-days. A significantly higher HR for the incidence of sepsis was found in men (1.54, 95% CI: 1.14-2.07), APACHE II ≥21 (2.92, 95% CI: 1.92-4.44), ventilator use (3.30, 95% CI: 1.98-5.49), and central venous catheter use (3.45, 95% CI: 1.90-6.28). SMR was determined to be 1.18 (95% CI: 0.82-1.21) in NI patients without sepsis and 2.43 (95% CI: 1.88-3.09) in NI patients with sepsis. Mean LOS for survivors was calculated to be 11.8 days (95% CI: 11.3-12.4) in NI patients without sepsis and 15.0 days (95% CI: 13.3-17.0) in NI patients with sepsis compared with 3.8 days (95% CI: 3.8-3.9) in patients without NI.

Conclusions: Sepsis is not very common in Japanese ICUs, but its development leads to further increases in mortality and LOS in patients with NI.

Keywords: ICU; incidence; length of stay; mortality; sepsis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1378/chest.101.6.1644', 'is_inner': False, 'url': 'https://doi.org/10.1378/chest.101.6.1644'}, {'type': 'PubMed', 'value': '1303622', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/1303622/'}]}
    2. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101:1644–1655. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/01.CCM.0000050454.01978.3B', 'is_inner': False, 'url': 'https://doi.org/10.1097/01.ccm.0000050454.01978.3b'}, {'type': 'PubMed', 'value': '12682500', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12682500/'}]}
    2. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003; 31:1250–1256. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00003246-200107000-00002', 'is_inner': False, 'url': 'https://doi.org/10.1097/00003246-200107000-00002'}, {'type': 'PubMed', 'value': '11445675', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/11445675/'}]}
    2. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303–1310. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1056/NEJMoa022139', 'is_inner': False, 'url': 'https://doi.org/10.1056/nejmoa022139'}, {'type': 'PubMed', 'value': '12700374', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12700374/'}]}
    2. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546–1554. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/jama.274.12.968', 'is_inner': False, 'url': 'https://doi.org/10.1001/jama.274.12.968'}, {'type': 'PubMed', 'value': '7674528', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/7674528/'}]}
    2. Brun-Buisson C, Doyon F, Carlet J, Dellamonica P, Gouin F, Lepoutre A, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults: a multicenter prospective study in intensive care units. JAMA. 1995;274: 968–974. - PubMed