Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: The FORECAST study

Toshikazu Abe; Hiroshi Ogura; Atsushi Shiraishi; Shigeki Kushimoto; Daizoh Saitoh; Seitaro Fujishima; Toshihiko Mayumi; Yasukazu Shiino; Taka Aki Nakada; Takehiko Tarui; Toru Hifumi; Yasuhiro Otomo; Kohji Okamoto; Yutaka Umemura; Joji Kotani; Yuichiro Sakamoto; Junichi Sasaki; Shin Ichiro Shiraishi; Kiyotsugu Takuma; Ryosuke Tsuruta; Akiyoshi Hagiwara; Kazuma Yamakawa; Tomohiko Masuno; Naoshi Takeyama; Norio Yamashita; Hiroto Ikeda; Masashi Ueyama; Satoshi Fujimi; Satoshi Gando; Osamu Tasaki; Yasumitsu Mizobata; Hiraku Funakoshi; Toshiro Okuyama; Iwao Yamashita; Toshio Kanai; Yasuo Yamada; Mayuki Aibiki; Keiji Sato; Susumu Yamashita; Kenichi Yoshida; Shunji Kasaoka; Akihide Kon; Hiroshi Rinka; Hiroshi Kato; Hiroshi Okudera; Eichi Narimatsu; Toshifumi Fujiwara; Manabu Sugita; Yasuo Shichinohe; Hajime Nakae; Ryouji Iiduka; Mitsunobu Nakamura; Yuji Murata; Yoshitake Sato; Hiroyasu Ishikura; Yasuhiro Myojo; Yasuyuki Tsujita; Kosaku Kinoshita; Hiroyuki Yamaguchi; Toshihiro Sakurai; Satoru Miyatake; Takao Saotome; Susumu Yasuda

doi:10.1186/s13054-018-2186-7

Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: The FORECAST study

Toshikazu Abe^*, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Taka Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke TsurutaAkiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando, Osamu Tasaki, Yasumitsu Mizobata, Hiraku Funakoshi, Toshiro Okuyama, Iwao Yamashita, Toshio Kanai, Yasuo Yamada, Mayuki Aibiki, Keiji Sato, Susumu Yamashita, Kenichi Yoshida, Shunji Kasaoka, Akihide Kon, Hiroshi Rinka, Hiroshi Kato, Hiroshi Okudera, Eichi Narimatsu, Toshifumi Fujiwara, Manabu Sugita, Yasuo Shichinohe, Hajime Nakae, Ryouji Iiduka, Mitsunobu Nakamura, Yuji Murata, Yoshitake Sato, Hiroyasu Ishikura, Yasuhiro Myojo, Yasuyuki Tsujita, Kosaku Kinoshita, Hiroyuki Yamaguchi, Toshihiro Sakurai, Satoru Miyatake, Takao Saotome, Susumu Yasuda

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研究成果: ジャーナルへの寄稿 › 学術論文 › 査読

90 被引用数 (Scopus)

抄録

Background: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. Methods: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria. Results: In total, 1184 patients (median age 73 years, interquartile range (IQR) 64-81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6-11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21-26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12-46) days. Approximately 37% of the patients were discharged home after recovery. Conclusion: Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan. Trial registration: UMIN-CTR, UMIN000019742. Registered on 16 November 2015.

本文言語	英語
論文番号	322
ジャーナル	Critical Care
巻	22
号	1
DOI	https://doi.org/10.1186/s13054-018-2186-7
出版ステータス	出版済み - 2018/11/22

ASJC Scopus 主題領域

集中医療医学

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10.1186/s13054-018-2186-7

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引用スタイル

Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S., Mayumi, T., Shiino, Y., Nakada, T. A., Tarui, T., Hifumi, T., Otomo, Y., Okamoto, K., Umemura, Y., Kotani, J., Sakamoto, Y., Sasaki, J., Shiraishi, S. I., Takuma, K., ... Yasuda, S. (2018). Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: The FORECAST study. Critical Care, 22(1), 記事 322. https://doi.org/10.1186/s13054-018-2186-7

@article{0bb161ab2c064fccb80e3db8c779f3ba,

title = "Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: The FORECAST study",

abstract = "Background: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. Methods: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria. Results: In total, 1184 patients (median age 73 years, interquartile range (IQR) 64-81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6-11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21-26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12-46) days. Approximately 37% of the patients were discharged home after recovery. Conclusion: Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan. Trial registration: UMIN-CTR, UMIN000019742. Registered on 16 November 2015.",

keywords = "Bundle, Elderly, Resuscitation, Sepsis",

author = "Toshikazu Abe and Hiroshi Ogura and Atsushi Shiraishi and Shigeki Kushimoto and Daizoh Saitoh and Seitaro Fujishima and Toshihiko Mayumi and Yasukazu Shiino and Nakada, {Taka Aki} and Takehiko Tarui and Toru Hifumi and Yasuhiro Otomo and Kohji Okamoto and Yutaka Umemura and Joji Kotani and Yuichiro Sakamoto and Junichi Sasaki and Shiraishi, {Shin Ichiro} and Kiyotsugu Takuma and Ryosuke Tsuruta and Akiyoshi Hagiwara and Kazuma Yamakawa and Tomohiko Masuno and Naoshi Takeyama and Norio Yamashita and Hiroto Ikeda and Masashi Ueyama and Satoshi Fujimi and Satoshi Gando and Osamu Tasaki and Yasumitsu Mizobata and Hiraku Funakoshi and Toshiro Okuyama and Iwao Yamashita and Toshio Kanai and Yasuo Yamada and Mayuki Aibiki and Keiji Sato and Susumu Yamashita and Kenichi Yoshida and Shunji Kasaoka and Akihide Kon and Hiroshi Rinka and Hiroshi Kato and Hiroshi Okudera and Eichi Narimatsu and Toshifumi Fujiwara and Manabu Sugita and Yasuo Shichinohe and Hajime Nakae and Ryouji Iiduka and Mitsunobu Nakamura and Yuji Murata and Yoshitake Sato and Hiroyasu Ishikura and Yasuhiro Myojo and Yasuyuki Tsujita and Kosaku Kinoshita and Hiroyuki Yamaguchi and Toshihiro Sakurai and Satoru Miyatake and Takao Saotome and Susumu Yasuda",

note = "Publisher Copyright: {\textcopyright} 2018 The Author(s).",

year = "2018",

month = nov,

day = "22",

doi = "10.1186/s13054-018-2186-7",

language = "英語",

volume = "22",

journal = "Critical Care",

issn = "1364-8535",

publisher = "BioMed Central Ltd.",

number = "1",

}

Abe, T, Ogura, H, Shiraishi, A, Kushimoto, S, Saitoh, D, Fujishima, S, Mayumi, T, Shiino, Y, Nakada, TA, Tarui, T, Hifumi, T, Otomo, Y, Okamoto, K, Umemura, Y, Kotani, J, Sakamoto, Y, Sasaki, J, Shiraishi, SI, Takuma, K, Tsuruta, R, Hagiwara, A, Yamakawa, K, Masuno, T, Takeyama, N, Yamashita, N, Ikeda, H, Ueyama, M, Fujimi, S, Gando, S, Tasaki, O, Mizobata, Y, Funakoshi, H, Okuyama, T, Yamashita, I, Kanai, T, Yamada, Y, Aibiki, M, Sato, K, Yamashita, S, Yoshida, K, Kasaoka, S, Kon, A, Rinka, H, Kato, H, Okudera, H, Narimatsu, E, Fujiwara, T, Sugita, M, Shichinohe, Y, Nakae, H, Iiduka, R, Nakamura, M, Murata, Y, Sato, Y, Ishikura, H, Myojo, Y, Tsujita, Y, Kinoshita, K, Yamaguchi, H, Sakurai, T, Miyatake, S, Saotome, T & Yasuda, S 2018, 'Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: The FORECAST study', Critical Care, vol. 22, no. 1, 322. https://doi.org/10.1186/s13054-018-2186-7

TY - JOUR

T1 - Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan

T2 - The FORECAST study

AU - Abe, Toshikazu

AU - Ogura, Hiroshi

AU - Shiraishi, Atsushi

AU - Kushimoto, Shigeki

AU - Saitoh, Daizoh

AU - Fujishima, Seitaro

AU - Mayumi, Toshihiko

AU - Shiino, Yasukazu

AU - Nakada, Taka Aki

AU - Tarui, Takehiko

AU - Hifumi, Toru

AU - Otomo, Yasuhiro

AU - Okamoto, Kohji

AU - Umemura, Yutaka

AU - Kotani, Joji

AU - Sakamoto, Yuichiro

AU - Sasaki, Junichi

AU - Shiraishi, Shin Ichiro

AU - Takuma, Kiyotsugu

AU - Tsuruta, Ryosuke

AU - Hagiwara, Akiyoshi

AU - Yamakawa, Kazuma

AU - Masuno, Tomohiko

AU - Takeyama, Naoshi

AU - Yamashita, Norio

AU - Ikeda, Hiroto

AU - Ueyama, Masashi

AU - Fujimi, Satoshi

AU - Gando, Satoshi

AU - Tasaki, Osamu

AU - Mizobata, Yasumitsu

AU - Funakoshi, Hiraku

AU - Okuyama, Toshiro

AU - Yamashita, Iwao

AU - Kanai, Toshio

AU - Yamada, Yasuo

AU - Aibiki, Mayuki

AU - Sato, Keiji

AU - Yamashita, Susumu

AU - Yoshida, Kenichi

AU - Kasaoka, Shunji

AU - Kon, Akihide

AU - Rinka, Hiroshi

AU - Kato, Hiroshi

AU - Okudera, Hiroshi

AU - Narimatsu, Eichi

AU - Fujiwara, Toshifumi

AU - Sugita, Manabu

AU - Shichinohe, Yasuo

AU - Nakae, Hajime

AU - Iiduka, Ryouji

AU - Nakamura, Mitsunobu

AU - Murata, Yuji

AU - Sato, Yoshitake

AU - Ishikura, Hiroyasu

AU - Myojo, Yasuhiro

AU - Tsujita, Yasuyuki

AU - Kinoshita, Kosaku

AU - Yamaguchi, Hiroyuki

AU - Sakurai, Toshihiro

AU - Miyatake, Satoru

AU - Saotome, Takao

AU - Yasuda, Susumu

PY - 2018/11/22

Y1 - 2018/11/22

N2 - Background: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. Methods: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria. Results: In total, 1184 patients (median age 73 years, interquartile range (IQR) 64-81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6-11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21-26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12-46) days. Approximately 37% of the patients were discharged home after recovery. Conclusion: Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan. Trial registration: UMIN-CTR, UMIN000019742. Registered on 16 November 2015.

AB - Background: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. Methods: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017. We included adult patients with severe sepsis based on the sepsis-2 criteria. Results: In total, 1184 patients (median age 73 years, interquartile range (IQR) 64-81) with severe sepsis were admitted to the ICU during the study period. The most common comorbidity was diabetes mellitus (23%). Moreover, approximately 63% of patients had septic shock. The median Sepsis-related Organ Failure Assessment (SOFA) score was 9 (IQR 6-11). The most common site of infection was the lung (31%). Approximately 54% of the participants had positive blood cultures. The compliance rates for the entire 3-h bundle, measurement of central venous pressure, and assessment of central venous oxygen saturation were 64%, 26%, and 7%, respectively. A multilevel logistic regression model showed that closed ICUs and non-university hospitals were more compliant with the entire 3-h bundle. The in-hospital mortality rate of patients with severe sepsis was 23% (21-26%). Older age, multiple comorbidities, suspected site of infection, and increasing SOFA scores correlated with in-hospital mortality, based on the generalized estimating equation model. The length of hospital stay was 24 (12-46) days. Approximately 37% of the patients were discharged home after recovery. Conclusion: Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h bundle and low compliance rate for central venous catheter measurements. The in-hospital mortality rate in Japan was comparable to that of other developed countries. Only one third of the patients were discharged home, considering the aging population with multiple comorbidities in the ICUs in Japan. Trial registration: UMIN-CTR, UMIN000019742. Registered on 16 November 2015.

KW - Bundle

KW - Elderly

KW - Resuscitation

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=85057092937&partnerID=8YFLogxK

U2 - 10.1186/s13054-018-2186-7

DO - 10.1186/s13054-018-2186-7

M3 - 学術論文

C2 - 30466493

AN - SCOPUS:85057092937

SN - 1364-8535

VL - 22

JO - Critical Care

JF - Critical Care

IS - 1

M1 - 322

ER -