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The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study.

Title: The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study.
Authors: Quenot, Jean-Pierre; Binquet, Christine; Kara, Fady; Martinet, Olivier; Ganster, Frederique; Navellou, Jean-Christophe; Castelain, Vincent; Barraud, Damien; Cousson, Joel; Louis, Guillaume; Perez, Pierre; Kuteifan, Khaldoun; Noirot, Alain; Badie, Julio; Mezher, Chaouki; Lessire, Henry; Pavon, Arnaud
Contributors: Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC); Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM); Service de Réanimation Médicale (CHU de Dijon); Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon); Service de réanimation polyvalente; Centre hospitalier de Haguenau; Service de réanimation Médicale; Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg); Hôpitaux Universitaires de Strasbourg (HUS)-Hôpitaux Universitaires de Strasbourg (HUS); Service de Réanimation médicale CHRU Besançon; Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon); Service de réanimation médicale; Hôpitaux Universitaires de Strasbourg (HUS)-Hôpitaux Universitaires de Strasbourg (HUS)-Hôpital de Hautepierre Strasbourg; Hôpitaux Universitaires de Strasbourg (HUS); Service de Réanimation Médicale CHRU Nancy; Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); Hôpital universitaire Robert Debré Reims (CHU Reims); Centre hospitalier régional de Metz-Thionville (CHR Metz-Thionville); Centre Hospitalier Emile Muller Mulhouse (CH E.Muller Mulhouse); Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA); Centre Hospitalier de Vesoul (CH Vesoul); Groupe Hospitalier de La Haute-Saône (GH70)-Groupe Hospitalier de La Haute-Saône (GH70); CH Belfort-Montbéliard; CH Montbéliard; CH Colmar
Source: ISSN: 1364-8535.
Publisher Information: CCSD; BioMed Central
Publication Year: 2013
Collection: Université de Bourgogne (UB): HAL
Subject Terms: [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]
Description: International audience ; INTRODUCTION: To provide up-to-date information on the prognostic factors associated with 28-day mortality in a cohort of septic shock patients in intensive care units (ICUs). METHODS: Prospective, multicenter, observational cohort study in ICUs from 14 French general (non-academic) and university teaching hospitals. All consecutive patients with septic shock admitted between November 2009 and March 2011 were eligible for inclusion. We prospectively recorded data regarding patient characteristics, infection, severity of illness, life support therapy and discharge. RESULTS: Among 10,941 patients admitted to participating ICUs between October 2009 and September 2011, 1495 (13.7%) patients presented inclusion criteria for septic shock and were included. Invasive mechanical ventilation was needed in 83.9% (n=1248), inotropes in 27.7% (n=412), continuous renal replacement therapy in 32.5% (n=484) and hemodialysis in 19.6% (n=291). Mortality at 28 days was 42% (n=625). Variables associated with time to mortality, right-censored at day 28: age (for each additional 10 yrs) (hazard ratio, HR=1.29; 95% confidence interval [CI]: 1.20-1.38), immunosuppression (HR=1.63; 95%CI: 1.37-1.96), Knaus class C/D score versus class A/B score (HR=1.36; 95%CI:1.14-1.62) and Sepsis-related Organ Failure Assessment (SOFA) score (HR=1.24 for each additional point; 95%CI: 1.21-1.27). Patients with septic shock and renal/urinary tract infection had a significantly longer time to mortality (HR=0.56; 95%CI: 0.42-0.75). CONCLUSION: Our observational data of consecutive patients from real-life practice confirm that septic shock is common and carries high mortality in general intensive care unit populations. Our results are in contrast with the clinical trial setting, and could be useful for healthcare planning and clinical study design.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/23561510; PUBMED: 23561510
DOI: 10.1186/cc12598
Availability: https://inserm.hal.science/inserm-00873494; https://inserm.hal.science/inserm-00873494v1/document; https://inserm.hal.science/inserm-00873494v1/file/cc12598.pdf; https://doi.org/10.1186/cc12598
Rights: https://about.hal.science/hal-authorisation-v1/ ; info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.35489BAE
Database: BASE