[Epidemiology and costs of severe sepsis in Madrid. A hospital discharge study].

BACKGROUND AND

OBJECTIVE

Severe sepsis is a complex syndrome to define, diagnose and treat. This population-based study describes the epidemiology of sepsis in the Region of Madrid, estimates its incidence and mortality, and assesses its impact on hospital stays and costs.

PATIENTS AND

METHODS

The source of information was the Minimum Basic Hospital Data Set from the Region of Madrid in 2001. Severe sepsis cases were defined as discharges with a combination of organic failure and presence or suspicion of infection through a combination of codes previously proposed and utilized. A descriptive study was performed, incidence rates were calculated, lengths of stay and costs were estimated, and mortality was analyzed.

RESULTS

6,968 episodes were identified. Mean age was 62.5 year. 59.7% were male. Annual incidence was 14.1/10,000 inhabitants, being highest for those 84 and older (230.8/10,000). 1.7 infections per episode were detected. More frequently identified microorganisms were Streptococcus sp., Staphylococcus sp., Escherichia coli and Candida sp. The most frequent organic dysfunctions were renal (39.7%) and respiratory (35.7%). Mortality was 33%. Mortality was higher in cases with more than one organic failure, hepatic dysfunction or cancer. Mean length of stay was 28.9 day. Annual overall costs were 70 million euros.

CONCLUSIONS

Severe sepsis is a frequent process, with a high mortality and a significant impact on health care resource utilization.