The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study. - Archive ouverte HAL Access content directly
Journal Articles Critical Care Year : 2013

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

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Fady Kara
  • Function : Author
  • PersonId : 946877
Olivier Martinet
  • Function : Author
  • PersonId : 926120
Frederique Ganster
  • Function : Author
  • PersonId : 946878
Vincent Castelain
  • Function : Author
  • PersonId : 946880
Joel Cousson
  • Function : Author
  • PersonId : 946881
Guillaume Louis
  • Function : Author
  • PersonId : 946882
Pierre Perez
  • Function : Author
  • PersonId : 946883
Khaldoun Kuteifan
  • Function : Author
  • PersonId : 946884
Alain Noirot
  • Function : Author
  • PersonId : 946885
Julio Badie
  • Function : Author
  • PersonId : 946886
Chaouki Mezher
  • Function : Author
  • PersonId : 946887
Henry Lessire
  • Function : Author
  • PersonId : 946888
Arnaud Pavon
  • Function : Author
  • PersonId : 946889

Abstract

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.
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Dates and versions

inserm-00873494 , version 1 (15-10-2013)

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Jean-Pierre Quenot, Christine Binquet, Fady Kara, Olivier Martinet, Frederique Ganster, et al.. The epidemiology of septic shock in French intensive care units: the prospective multicenter cohort EPISS study.. Critical Care, 2013, 17 (2), pp.R65. ⟨10.1186/cc12598⟩. ⟨inserm-00873494⟩
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