Author/Authors :
Kim, Jae Yeol Department of Internal Medicine - Chung-Ang University College of Medicine - Seoul, Korea , Kim, Hwan Il Department of Internal Medicine - Hallym University Medical Center - Anyang, Korea , Suh, Gee Young Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine - Seoul, Korea , Yoon, Sang Won Department of Internal Medicine - Chung-Ang University College of Medicine - Seoul, Korea , Kim, Tae-Yop Department of Anesthesiology - Konkuk University Medical Center - Konkuk University School of Medicine - Seoul, Korea , Lee, Sang Haak Department of Internal Medicine - St. Paul’s Hospital - College of Medicine - The Catholic University of Korea - Seoul, Korea , Moon, Jae Young Department of Internal Medicine - Chungnam National University Hospital - Daejeon, Korea , Kwon, Jae-Young Department of Anesthesia and Pain Medicine - Pusan National University School of Medicine - Busan, Korea , Na, Sungwon Department of Anesthesia and Pain Medicine - Yonsei University College of Medicine - Seoul, Korea , Ryu, Ho Geol Department of Anesthesiology and Pain Medicine - Seoul National University College of Medicine - Seoul, Korea , Park, Jisook Department of Software Convergence - Seoul Women’s University - Seoul, Korea , Koh, Younsuck Department of Pulmonary and Critical Care Medicine - Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea
Abstract :
Background: The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis
with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based
approach, East Asian descents comprised minor portions of the project population.
Methods: We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the
concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated
mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria
using the selected data.
Results: Korean participants of the FACE study were 913 (383 with sepsis and 530 without
sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and
Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis,
sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were
26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality.
Conclusions: The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made
by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting
ICU and 28-day mortality in Korean ICU patients.
Keywords :
intensive care units , organ dysfunction , Sepsis , Sepsis-3 , septic shock
