Author/Authors :
Jeon, Kyeongman Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine - Seoul, Korea , Na, Soo Jin Department of Critical Care Medicine - Samsung Medical Center - Sungkyunkwan University School of Medicine - Seoul, Korea , Oh, Dong Kyu Department of Pulmonary and Critical Care Medicine - Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Park, Sunghoon Department of Pulmonary - Allergy and Critical Care Medicine - Hallym University Sacred Heart Hospital - Anyang, Korea , Choi, Eun Young Department of Internal Medicine - Yeungnam University Medical Center - Daegu, Korea , Kim, Seok Chan Department of Medicine - Seoul St. Mary’s Hospital - College of Medicine - The Catholic University of Korea - Seoul, Korea , Seong, Gil Myeong Department of Internal Medicine - Jeju National University Hospital - Jeju National University School of Medicine - Jeju, Korea , Heo, Jeongwon Department of Internal Medicine - Kangwon National University Hospital - Chuncheon, Korea , Chang, Youjin Department of Internal Medicine - Inje University Sanggye Paik Hospital - Seoul, Korea , Kwack, Won Gun Department of Internal Medicine - Kyung Hee University Hospital - Seoul, Korea , Kang, Byung Ju Department of Internal Medicine - Ulsan University Hospital - University of Ulsan College of Medicine - Ulsan, Korea , Choi, Won-Il Department of Medicine - Keimyung University Dongsan Medical Center - Daegu, Korea , Kim, Kyung Chan Department of Internal Medicine - Daegu Catholic University Medical Center - Daegu Catholic University College of Medicine - Daegu, Korea , Park, So Young Department of Internal Medicine - Chungnam National University Hospital - Daejeon, Korea , Kwak, Sang Hyun Department of Anesthesiology - Chonnam National University Hospital - Gwangju, Korea , Shin, Yoon Mi Department of Internal Medicine - Chungbuk National University Hospital - Cheongju, Korea , Lee, Heung Bum Department of Internal Medicine - Research Center for Pulmonary Disorders - Chonbuk National University Medical School - Jeonju, Korea , Park, So Hee Department of Internal Medicine - Inje University Ilsan Paik Hospital - Inje University College of Medicine - Goyang, Korea , Cho, Jae Hwa Department of Internal Medicine - Gangnam Severance Hospital - Yonsei University College of Medicine - Seoul, Korea , Kim, Beongki Department of Internal Medicine - Korea University Ansan Hospital - Ansan, Korea , Lim, Chae-Man Department of Pulmonary and Critical Care Medicine - Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea
Abstract :
Background: Mortality rates associated with sepsis have increased progressively in Korea, but
domestic epidemiologic data remain limited. The objective of this study was to investigate
the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods: This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals
during a 1-month period were screened for eligibility. Among these, patients diagnosed with
sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock
(Sepsis-3) were included in the study.
Results: Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5%
presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections
associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%,
P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without
shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to
home and 38.6% were transferred to other hospitals or facilities.
Conclusions: This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high
mortality and were often referred to step-down centers after acute and critical care.
