SynthesisCritical care medicine2014
Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis*.
Synthesis in Critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 331 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
331 citing papers in PubMed, 7 syntheses or guidelines pooled it, 653 citations in OpenAlex.
- Sepsis mortality prediction using machine learning and deep learning - a systematic review.BMC medical informatics and decision making · 2025Pooled it
- Analysis of structure indicators influencing 3-h and 6-h compliance with the surviving sepsis campaign guidelines in China: a systematic review.European journal of medical research · 2021Pooled it
- Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019- results from a systematic review and meta-analysis.Critical care (London, England) · 2020Pooled it
- Trends in sepsis mortality over time in randomised sepsis trials: a systematic literature review and meta-analysis of mortality in the control arm, 2002-2016.Critical care (London, England) · 2019Pooled it
- Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis.JAMA pediatrics · 2019Pooled it
- Scaling beta-lactam antimicrobial pharmacokinetics from early life to old age.British journal of clinical pharmacology · 2019Pooled it
- A model-based cost-effectiveness analysis of Patient Blood Management.Blood transfusion = Trasfusione del sangue · 2019Pooled it
- Trial
- Electro-acupuncture attenuates inflammatory responses and intraabdominal pressure in septic patients: A randomized controlled trial.Medicine · 2018Trial
- Loss of Function Dnmt3a Mutation Leads to Aberrant Neutrophil Migration.Experimental hematology · 2026Article
- Systems Bioengineering of Septic Shock Metabolism: Citrulline, β-Hydroxybutyrate and Plasma Biomarker-Based Phenotyping.Biomolecules · 2026Review
- Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years.Antibiotics (Basel, Switzerland) · 2026Article
- The impact of community-acquired critical sepsis on long-term mortality and morbidity-a nationwide cohort study.Scientific reports · 2026Article
- Pathogen characteristics are key determinants of distinct host response phenotypes of sepsis.The Journal of clinical investigation · 2026Observational
- A dataset of paired blood mRNA and microRNA sequencing across acute septic shock and recovery.Scientific data · 2026Article
- Refractory septic shock: our updated pragmatic approach.Journal of anesthesia, analgesia and critical care · 2026Review
- The immunology of sepsis: translating new insights into clinical practice.Nature reviews. Nephrology · 2026Review
- Validation of CRownLab Pneumoplex for the Detection ofInternational journal of microbiology · 2026Article
- The association between interhospital transfer and sepsis guideline adherence among rural emergency department patients.PloS one · 2026Article
- Article
271 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTrends in severe sepsis mortality derived from administrative data may be biased by changing International Classification of Diseases, 9th Revision, Clinical Modification, coding practices. We sought to determine temporal trends in severe sepsis mortality using clinical trial data that does not rely on International Classification of Diseases, 9th Revision, Clinical Modifications coding and compare mortality trends in trial data with those observed from administrative data.
designWe searched MEDLINE for multicenter randomized trials that enrolled patients with severe sepsis from 1991 to 2009. We calculated standardized mortality ratios for each trial from observed 28-day mortality of usual care participants and predicted mortality from severity-of-illness scores. To compare mortality trends from clinical trials to administrative data, we identified adult severe sepsis hospitalizations in the Nationwide Inpatient Sample, 1993-2009, using two previously validated algorithms.
settingIn-patient. PATIENTS: Patients with severe sepsis or septic shock.
interventionsNone. MEASUREMENTS AND MAIN
resultsOf 3,244 potentially eligible articles, we included 36 multicenter severe sepsis trials, with a total of 14,418 participants in a usual care arm. Participants with severe sepsis receiving usual care had a 28-day mortality of 33.2%. Observed mortality decreased 3.0% annually (95% CI, 0.8%-5.0%; p = 0.009), decreasing from 46.9% (standardized mortality ratio 0.94; 95% CI, 0.86-1.03) during years 1991-1995 to 29% (standardized mortality ratio 0.53; 95% CI, 0.50-0.57) during years 2006-2009 (3.0% annual change). Trends in hospital mortality among patients with severe sepsis identified from administrative data (Angus definition, 4.7% annual change; 95% CI, 4.1%-5.3%; p = 0.69 and Martin definition, 3.5% annual change; 95% CI, 3.0%-4.1%; p = 0.97) were similar to trends identified from clinical trials.
conclusionSince 1991, patients with severe sepsis enrolled in usual care arms of multicenter randomized trials have experienced decreasing mortality. The mortality trends identified in clinical trial participants appear similar to those identified using administrative data and support the use of administrative data to monitor mortality trends in patients with severe sepsis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.