ArticleJournal of intensive care2019
Variations in infection sites and mortality rates among patients in intensive care units with severe sepsis and septic shock in Japan.
Article in Journal of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed.
- Article
- Bile acid dysregulation in sepsis: mechanisms, clinical implications, and future perspectives.Frontiers in cellular and infection microbiology · 2026Review
- Outcomes of septic shock from urinary and non-urinary sources in nonagenarians and centenarians admitted to intensive care units.Scientific reports · 2025Article
- Frailty as an Independent Predictor of Mortality in Patients with Sepsis.Journal of personalized medicine · 2025Article
- Time to administer polymyxin B hemoperfusion and hemodynamics in patients with septic shock requiring high-dose norepinephrine: a predetermined analysis of a prospective cohort study.Critical care (London, England) · 2025Article
- A Retrospective Single-Center Analysis from Southern Italy on the Use of T2 Magnetic Resonance Assays as a Point-of-Care Method for Patients with Sepsis.Biomedicines · 2025Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- Epidemiology of sepsis-associated acute kidney injury in critically ill patients: a multicenter, prospective, observational cohort study in South Korea.Critical care (London, England) · 2024Observational
- Infectious Foci, Comorbidities and Its Influence on the Outcomes of Septic Critically Ill Patients.Microorganisms · 2024Article
- Article
- Observational
- mTOR signaling pathway regulation HIF-1 α effects on LPS induced intestinal mucosal epithelial model damage.BMC molecular and cell biology · 2024Article
- Beyond Septic Shock: Who Else Requires Immediate Antibiotics?American journal of respiratory and critical care medicine · 2024Article
- Article
- Sepsis among Adults Admitted to Intensive Care Unit of a Tertiary Care Centre.JNMA; journal of the Nepal Medical Association · 2024Article
- Article
- Mortality due to Sepsis and Its Associated Factors Among Patients Admitted to Intensive Care Units of Southern Amhara Public Hospitals, Ethiopia.BioMed research international · 2024Article
- Association Between the Site of Infection and Mortality Analysis in Critically Ill Surgical Patients.Cureus · 2023Article
- Sepsis heterogeneity.World journal of pediatrics : WJP · 2023Review
- Fast Track Diagnostic Tools for Clinical Management of Sepsis: Paradigm Shift from Conventional to Advanced Methods.Diagnostics (Basel, Switzerland) · 2023Review
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34 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate and early identification of infection sites might help to drive crucial decisions regarding the treatment of sepsis. We aimed to determine the clinical and etiological features of infection according to sites among patients with severe sepsis in Japan.
methodsThis secondary analysis of a multicenter, prospective cohort study included 59 intensive care units (ICU) and proceeded between January 2016 and March 2017. The study cohort comprised 1184 adults (≥ 16 years) who were admitted to an ICU with severe sepsis and septic shock diagnosed according to the sepsis-2 criteria. Sites of infection diagnosed by physicians in charge at the time of arrival comprised the lung, abdomen, urinary tract, soft tissue, bloodstream, central nervous system (CNS), and undifferentiated infections. The primary outcome was in-hospital mortality.
resultsThe most common sites of infection were the lungs (31.0%), followed by intra-abdominal sites (26.3%), the urinary tract (18.4%), and soft tissue (10.9%). The characteristics of the patients with severe sepsis across seven major suspected infection sites were heterogeneous. Septic shock was more frequent among patients with intra-abdominal (72.2%) and urinary tract (70.2%) infections than other sites. The in-hospital mortality rate due to severe sepsis and septic shock of a pooled sample was 23.4% (range, 11.9% [urinary tract infection] to 47.6% [CNS infection]). After adjusting for clinical background, sepsis severity, and stratification according to the presence or absence of shock, variations in hospital mortality across seven major sites of infection remained essentially unchanged from those for crude in-hospital mortality; adjusted in-hospital mortality rates ranged from 7.7% (95%CI, - 0.3 to 15.8) for urinary tract infection without shock to 58.3% (95%CI, 21.0-95.7) for CNS infection with shock in a generalized estimating equation model. Intra-abdominal and urinary tract infections were statistically associated with less in-hospital mortality than pneumonia. Infections of the CNS were statistically associated with higher in-hospital mortality rates than pneumonia in a logistic regression model, but not in the generalized estimating equation model.
conclusionsIn-hospital mortality and clinical features of patients with severe sepsis and septic shock were heterogeneous according to sites of infection.
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