1. Kazım Rollas, Pervin Hancı, Kezban Ozmen Süner, Nesrin Damla Eyüpoglu,
Ozgür Kılıç, Burçin Halaclı, Mehmet Nezir Güllü, Nazmiye Ebru Ersoy Ortac,
Serpil Göcmen, Arzu Topeli
Medical Intensive Care Unit, Faculty of Medicine, Hacettepe
University, Ankara, Turkey
2. INTRODUCTION
Even in the developed countries, the frequency of
sepsis is increasing.
Sepsis is the most common cause of death in non-
coronary intensive care units (*).
There is not enough data available concerning the
epidemiology of sepsis in our country.
* 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. OBJECTIVE
We aimed to investigate the frequency and general
characteristics of the severe sepsis and septic shock
patients in our unit.
4. METHOD
The records of all patients admitted to the medical ICU of
Hacettepe university hospital between 1st January 2007 and
31st December 2014 were retrospectively reviewed from
unit’s database and hospital electronic records. Severe
sepsis and septic shock patients were included
Data are presented as number of cases (%) and median
(minimum–maximum).
5. RESULTS
Over the 8 year period, 1507 patients were admitted to
ICU.
Of those,104 patients who had less than 24 hours of
hospitalization were excluded.
464 (33.1%) of 1403 patients were admitted to ICU with
severe sepsis and septic shock.
224 (48.3 %) patients died in the ICU.
269 (58 %) patients died during the hospital stay.
Mean expected mortality rate adjusted for APACHE II
score was 48.1%.
11. The frequency and mortality rates of severe sepsis and
septic shock patients over the years
33,5
37,5
21,3
37,9 38,5
36,3 35,7
24,5
55,5
43,4
37,8
53,4
48,3
46,7
50,8 51
58,4
52,1 51,3
63,1
57,6
59,6 60,6
65,3
0
10
20
30
40
50
60
70
2007
APACHE II
26 (11-48)
2008
APACHE II
28 (10-52)
2009
APACHE II
26 (9-59)
2010
APACHE II
26(10-46)
2011
APACHE II
18 (7-34)
2012
APACHE II
20 (5-44)
2013
APACHE II
19 (8-43)
2014
APACHE II
24 (10-43)
The frequency of severe sepsis and
septic shock
Mortality in ICU
Mortality in hospital
The frequency is lower in 2009 and 2014 ( respectively p <0.01 and p<0,01)
p = 0.87 for ICU mortality over the years
p= 0.14 for hospital mortality over the years
12. DISCUSSION
Frequency of severe sepsis/ septic shock was 33 % in
our unit’s large patient sample.
Frequency of severe sepsis was detected as 30% for
European Intensive Care Units by Vincent et al (SOAP
trial).
Vincent JL, Sakr Y, Sprung CL, Reinhart MR, et al. Sepsis in European Intensive Care Units: Result of the
SOAP Study. Crit Care Med, 2006; 34: 344-353
13. Mortality of patients with severe sepsis and septic
shock was found as 48.3 % in our intensive care unit.
In SOAP trial, mortality of severe sepsis and septic
shock was 32% and 54 % respectively
14. The most common cause of sepsis was respiratory tract
(37.9 %), and the most frequent isolated agents were
gram negative microorganisms.
The most common cause of sepsis was found as
respiratory tract (40 %), and the most common agent
was found as gram negative bacterias by Mayr et al.
Mayr FB, Yende S, Linde-Zwirble WT, Peck-Palmer OM, Barnato AE, Weissfeld LA, Angus DC.
Infection rate and acute organ dysfunction risk as explanations for racial differences in severe
sepsis. JAMA. 2010;303:2495–503.
15. In our unit, there was differences in the frequency of sepsis
over the 8 years but significant change was not observed in
ICU and hospital mortality.
16. CONCLUSION
Severe sepsis/ septic shock remains a common disease
with high mortality in ICU.
In our counrty, there is a need for prospective multi-
center studies about sepsis epidemiology.
