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VOLUME 21 , ISSUE 9 ( 2017 ) > List of Articles


Epidemiology of adult-population sepsis in India: A single center 5 year experience

Sharmila Chatterjee, Mahuya Bhattacharya

Keywords : Epidemiology, intensive care patients, mortality, prevalence, severe sepsis

Citation Information : Chatterjee S, Bhattacharya M. Epidemiology of adult-population sepsis in India: A single center 5 year experience. Indian J Crit Care Med 2017; 21 (9):573-577.

DOI: 10.4103/ijccm.IJCCM_240_17

License: CC BY-ND 3.0

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2017; The Author(s).


Background and Aims: Sepsis is a major worldwide cause of morbidity and mortality. Most sepsis epidemiologic data are from the Western literature. Sparse data from India describe the epidemiology of infection rather than sepsis which is a host response to infection. This study describes the epidemiology of sepsis in the Intensive Care Unit (ICU) of an Indian tertiary care hospital. Subjects and Methods: A prospective study conducted between June 2006 and May 2011. All consecutively admitted patients during the 5 year study >=18 years of age were included and data obtained from hospital in-patient records. Variables measured were the incidence of severe sepsis, ICU, hospital, and 28-day mortality, the median length of ICU stay, median Acute Physiology and Chronic Health Evaluation II (APACHE II) score, infection site, and microbial profile. Results: There were 4711 admissions during the study with 282 (6.2%, 95% confidence interval 2.3, 13.1) admissions with severe sepsis. ICU mortality, hospital mortality, and 28-day mortality were 56%, 63.6%, and 62.8%, respectively. Predominant infection site was respiratory tract. The most common organisms were Gram-negative microbes. The most common microbe was Acinetobacter baumanni. Median APACHE II score on admission was 22 (interquartile range 16–28) and median length of ICU stay was 8 days. Severe sepsis attributable mortality was 85%. Conclusion: Severe sepsis is common in Indian ICUs and is mainly due to Gram-negative organisms. ICU mortality is high in this group and care is resource intensive due to increased length of stay.

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  1. Linde-Zwirble WT, Angus DC. Severe sepsis epidemiology: Sampling, selection, and society. Crit Care 2004;8:222-6.
  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;29:1303-10.
  3. Finfer S, Bellomo R, Lipman J, French C, Dobb G, Myburgh J. Adult-population incidence of severe sepsis in Australian and New Zealand Intensive Care Units. Intensive Care Med 2004;30:589-96.
  4. Alberti C, Brun-Buisson C, Burchardi H, Martin C, Goodman S, Artigas A, et al. Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med 2002;28:108-21.
  5. Harrison DA, Welch CA, Eddleston JM. The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: Secondary analysis of a high quality clinical database, the ICNARC Case Mix Programme Database. Crit Care 2006;10:R42.
  6. Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, et al. Sepsis in European Intensive Care Units: Results of the SOAP study. Crit Care Med 2006;34:344-53.
  7. Ghanshani RV, Gupta R, Sood S, Bansal A, Joad SH, Khedar RS. Epidemiology of infections in a medical ICU in India. Intensive Care Med 2014;40:456-7.
  8. Agarwal R, Gupta D, Ray P, Aggarwal AN, Jindal SK. Epidemiology, risk factors and outcome of nosocomial infections in a Respiratory Intensive Care Unit in North India. J Infect 2006;53:98-105.
  9. Ghanshani R, Gupta R, Gupta BS, Kalra S, Khedar RS, Sood S. Epidemiological study of prevalence, determinants, and outcomes of infections in medical ICU at a tertiary care hospital in India. Lung India 2015;32:441-8.
  10. Pradhan NP, Bhat SM, Ghadage DP. Nosocomial infections in the medical ICU: A retrospective study highlighting their prevalence, microbiological profile and impact on ICU stay and mortality. J Assoc Physicians India 2014;62:18-21.
  11. 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. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644-55.
  12. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699-709.
  13. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med 1985;13:818-29.
  14. Divatia JV, Amin PR, Ramakrishnan N, Kapadia FN, Todi S, Sahu S, et al. Intensive care in India: The Indian intensive care case mix and practice patterns study. Indian J Crit Care Med 2016;20:216-25.
  15. Salvo I, de Cian W, Musicco M, Langer M, Piadena R, Wolfler A, et al. The Italian SEPSIS study: Preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock. Intensive Care Med 1995;21 Suppl 2:S244-9.
  16. Pittet D, Rangel-Frausto S, Li N, Tarara D, Costigan M, Rempe L, et al. Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: Incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med 1995;21:302-9.
  17. 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. French ICU Group for Severe Sepsis. JAMA 1995;274:968-74.
  18. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA 2014;311:1308-16.
  19. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med 2016;193:259-72.
  20. Silva E, Pedro Mde A, Sogayar AC, Mohovic T, Silva CL, Janiszewski M, et al. Brazilian sepsis epidemiological study (BASES study). Crit Care 2004;8:R251-60.
  21. Sands KE, Bates DW, Lanken PN, Graman PS, Hibberd PL, Kahn KL, et al. Epidemiology of sepsis syndrome in 8 academic medical centers. JAMA 1997;278:234-40.
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