Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes
TLDR
The mortality with sepsis, particularly related to treating organ dysfunction, remains a priority to clinicians worldwide and is deserving of greater public health attention.Abstract:
Sepsis has been around since the dawn of time, having been described for more than 2000 years, although clinical definitions are recent. The consensus sepsis definitions have permitted worldwide epidemiological studies of sepsis to be conducted. We now recognize the common nature of sepsis and the consistency of its disease – particularly severe sepsis and septic shock. The incidence of sepsis, severe sepsis and septic shock continues to increase, and although Gram-positive bacterial pathogens remain the most common cause of sepsis, fungal organisms are increasing rapidly. We have made progress over the past half-century in identifying and treating patients with sepsis, and decreasing fatality rates reflect this progress. However, owing to the increasing incidence of sepsis, the number of people who die each year continues to increase. The mortality with sepsis, particularly related to treating organ dysfunction, remains a priority to clinicians worldwide and is deserving of greater public health attention.read more
Citations
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The immune system's role in sepsis progression, resolution, and long‐term outcome
Matthew J. Delano,Peter A. Ward +1 more
TL;DR: Efforts are focused on more clearly defining and effectively reversing the persistent immune cell dysfunction associated with long‐term sepsis mortality, which alters the innate and adaptive immune responses for sustained periods of time after clinical recovery.
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Epidemiology and Costs of Sepsis in the United States—An Analysis Based on Timing of Diagnosis and Severity Level*
TL;DR: The highest burden of incidence and total costs occurred in the lowest severity sepsis cohort population, and those with increasing severity had a higher economic burden and mortality on a case-by-case basis.
Journal ArticleDOI
Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis
Stefania Battista,Umberto Audisio,Claudia Galluzzo,Matteo Maggiorotto,Monica Masoero,Daniela Forno,Elisa Pizzolato,Marco Ulla,Manuela Lucchiari,Annarita Vitale,Corrado Moiraghi,Enrico Lupia,Fabio Settanni,Giulio Mengozzi +13 more
TL;DR: Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment, and no significant differences were found in copeptin temporal profile among different subgroups.
Journal ArticleDOI
MiRNA-Mediated Macrophage Polarization and its Potential Role in the Regulation of Inflammatory Response.
TL;DR: Recent findings in miRNA expression profiles in polarized macrophages from murine and human sources are highlighted, and how these miRNAs regulate macrophage polarization is summarized.
References
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Journal ArticleDOI
Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis
Roger C. Bone,Robert A. Balk,F. B. Cerra,R. P. Dellinger,A. M. Fein,William A. Knaus,Roland M. H. Schein,W. J. Sibbald +7 more
TL;DR: An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae as mentioned in this paper.
Journal ArticleDOI
The Epidemiology of Sepsis in the United States from 1979 through 2000
TL;DR: The rate of sepsis due to fungal organisms increased by 207 percent, with gram-positive bacteria becoming the predominant pathogens after 1987, and the total in-hospital mortality rate fell, yet the total number of deaths continued to increase.
Journal ArticleDOI
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
Mitchell M. Levy,Mitchell P. Fink,John C. Marshall,Edward Abraham,Derek C. Angus,Deborah J. Cook,Jonathan M. Cohen,Steven M. Opal,Jean Louis Vincent,Graham Ramsay +9 more
TL;DR: This document reflects a process whereby a group of experts and opinion leaders revisited the 1992 sepsis guidelines and found that apart from expanding the list of signs and symptoms of sepsi to reflect clinical bedside experience, no evidence exists to support a change to the definitions.
Journal ArticleDOI
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.
Anand Kumar,Daniel Roberts,Kenneth E. Wood,Bruce Light,Joseph E. Parrillo,Satendra Sharma,Robert Suppes,Daniel Feinstein,Sergio Zanotti,Leo Taiberg,David A. Gurka,Aseem Kumar,Mary Cheang +12 more
TL;DR: Effective antimicrobial administration within the first hour of documented hypotension was associated with increased survival to hospital discharge in adult patients with septic shock.
Journal ArticleDOI
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
Mitchell M. Levy,Mitchell P. Fink,John C. Marshall,Edward Abraham,Derek C. Angus,Deborah J. Cook,Jonathan M. Cohen,Steven M. Opal,Jean Louis Vincent,Graham Ramsay +9 more
TL;DR: A hypothetical model for staging sepsis is presented, which, in the future, may better characterize the syndrome on the basis of predisposing factors and premorbid conditions, the nature of the underlying infection, the characteristics of the host response, and the extent of the resultant organ dysfunction.
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