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Incidence and Outcomes of Sepsis in Korea: A Nationwide Cohort Study From 2007 to 2016

Oh, Seung-Young MD1,2; Cho, Songhee MS, MPH3; Kim, Ga Hee BS4; Jang, Eun Jin PhD5; Choi, Seongmi PhD4,6; Lee, Hannah MD, PhD7; Ryu, Ho Geol MD, PhD7

doi: 10.1097/CCM.0000000000004041
Online Clinical Investigations
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Objectives: This study aimed to estimate the incidence and clinical outcomes of sepsis in Korea from 2007 to 2016.

Design: Retrospective observational study.

Setting: Nationwide study with population-based healthcare reimbursement claims database.

Patients: Using data from the National Health Insurance Service of Korea, patients who were hospitalized with a diagnosis of sepsis from 2007 to 2016 were analyzed. The incidence of sepsis was calculated using mid-year census population and analyzed according to year, age, and sex. The Elixhauser Comorbidity Index score was calculated to adjust for the impact of comorbidities on clinical outcome. In-hospital mortality, hospital length of stay, ICU admission rates, and risk factors for in-hospital mortality were also analyzed.

Interventions: None.

Measurements and Main Results: The incidence of sepsis increased from 173.8 per 100,000 population in 2007 to 233.6 per 100,000 population in 2016. In-hospital mortality decreased from 30.9% in 2007 to 22.6% in 2016 (p < 0.0001). From 2007 to 2016, hospital length of stay and ICU admission rates associated with sepsis decreased from 26.0 ± 33.5 days to 21.3 ± 24.4 days (p < 0.0001) and from 16.2% to 12.7% (p < 0.0001), respectively. Male sex, age greater than 50 years, Elixhauser Comorbidity Index greater than 10, and mechanical ventilation were identified as risk factors for in-hospital mortality after adjusting for baseline characteristics.

Conclusions: The incidence of sepsis in Korea increased from 2007 to 2016, while the associated in-hospital mortality, hospital length of stay, and ICU admission rates decreased.

1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

2Critical Care Center, Seoul National University Hospital, Seoul, Korea.

3National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

4Department of Statistics, Kyungpook National University, Daegu, Korea.

5Department of Information Statistics, Andong National University, Andong, Korea.

6National Health Insurance Service, Health Insurance Policy Research Institute, Gangwon-do, Korea.

7Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea.

Dr. Ryu is the guarantor of the content of the article. Dr. Oh contributed substantially to the study design, data interpretation, and the writing of the first draft and subsequent revisions of the article. Dr. Cho, Ms. Kim, and Drs. Jang, Choi, and Lee contributed substantially to data analysis and interpretation, and the writing of the article. Dr. Ryu has contributed substantially to the study design, data analysis and interpretation, and the writing of the first draft and subsequent revisions of the article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).

The authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: hogeol@gmail.com

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