Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria

for the Korean Shock Society (KoSS) Investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results: Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P < 0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0-26.0) vs. 15.0 (10.0-20.3), respectively; P < 0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P < 0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P < 0.01). Conclusions: The new definition of septic shock successfully selected patients with greater severities and worse outcomes.

Original languageEnglish
Pages (from-to)845-853
Number of pages9
JournalJournal of Thoracic Disease
Volume10
Issue number2
DOIs
StatePublished - 1 Feb 2018

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Septic Shock
Sepsis
Mortality
Registries
APACHE
Hospital Mortality
Tertiary Care Centers
Hypotension
Observational Studies
Hospital Emergency Service
Comorbidity
Shock
Infection

Keywords

  • Mortality
  • Prognosis
  • Sepsis
  • Shock

Cite this

@article{6f95b7b7f4ca48989a254a6e9fdfaaf8,
title = "Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria",
abstract = "Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results: Of all 1,028 included patients, 574 (55.8{\%}) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1{\%} vs. 75.3{\%}, P < 0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0-26.0) vs. 15.0 (10.0-20.3), respectively; P < 0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1{\%} vs. 23.3{\%}; P < 0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8{\%} vs. 17.1{\%} and 25.1{\%} vs. 16.5{\%}, respectively; P < 0.01). Conclusions: The new definition of septic shock successfully selected patients with greater severities and worse outcomes.",
keywords = "Mortality, Prognosis, Sepsis, Shock",
author = "{for the Korean Shock Society (KoSS) Investigators} and Ryoo, {Seung Mok} and Kang, {Gu Hyun} and Shin, {Tae Gun} and Hwang, {Sung Yeon} and Kyuseok Kim and Jo, {You Hwan} and Park, {Yoo Seok} and Choi, {Sung Hyuk} and Yoon, {Young Hoon} and Kwon, {Woon Yong} and Suh, {Gil Joon} and Lim, {Tae Ho} and Han, {Kap Su} and Choi, {Han Sung} and Chung, {Sung Phil} and Kim, {Won Young}",
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doi = "10.21037/jtd.2018.01.96",
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Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria. / for the Korean Shock Society (KoSS) Investigators.

In: Journal of Thoracic Disease, Vol. 10, No. 2, 01.02.2018, p. 845-853.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria

AU - for the Korean Shock Society (KoSS) Investigators

AU - Ryoo, Seung Mok

AU - Kang, Gu Hyun

AU - Shin, Tae Gun

AU - Hwang, Sung Yeon

AU - Kim, Kyuseok

AU - Jo, You Hwan

AU - Park, Yoo Seok

AU - Choi, Sung Hyuk

AU - Yoon, Young Hoon

AU - Kwon, Woon Yong

AU - Suh, Gil Joon

AU - Lim, Tae Ho

AU - Han, Kap Su

AU - Choi, Han Sung

AU - Chung, Sung Phil

AU - Kim, Won Young

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results: Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P < 0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0-26.0) vs. 15.0 (10.0-20.3), respectively; P < 0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P < 0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P < 0.01). Conclusions: The new definition of septic shock successfully selected patients with greater severities and worse outcomes.

AB - Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results: Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P < 0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5±3.1 vs. 5.0±2.9, 9.3±3.8 vs. 6.6±3.4, and 20.0 (15.0-26.0) vs. 15.0 (10.0-20.3), respectively; P < 0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P < 0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P < 0.01). Conclusions: The new definition of septic shock successfully selected patients with greater severities and worse outcomes.

KW - Mortality

KW - Prognosis

KW - Sepsis

KW - Shock

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U2 - 10.21037/jtd.2018.01.96

DO - 10.21037/jtd.2018.01.96

M3 - Article

AN - SCOPUS:85042102280

VL - 10

SP - 845

EP - 853

JO - Journal of Thoracic Disease

JF - Journal of Thoracic Disease

SN - 2072-1439

IS - 2

ER -