Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people

Chien Chang Lee, Chia Hung Yo, Meng tse Gabriel Lee, Kuang Chau Tsai, Shih Hao Lee, Yueh Sheng Chen, Wan Chien Lee, Tzu Chun Hsu, Sie Hue Lee, Shy Shin Chang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives To determine the trend of incidence and outcome of sepsis based on a nationwide administrative database. Methods We analyzed the incidence and mortality of both emergency department treated and hospital treated sepsis from 2002 through 2012 using the entire health insurance claims data of Taiwan. The national health insurance covers 99% of residents in Taiwan. Sepsis patients were identified using a set of validated ICD-9CM codes conforming to the sepsis-3 definition. The 30-day all-cause mortality was verified by linked death certificate database. Results During the 11-year study period, a total of 1,259,578 episodes of sepsis was identified. The mean incidence rate was 639 per 100,000 person-years, increasing from 637.8/100,000 persons in 2002 to 772.1/100,000 persons in 2012 (annual increase: 1.9%). The mortality rate, however, has decreased from 27.8% in 2002 to 22.8% in 2012 (annual decrease: 0.45%). The trend of incidence and mortality did not change after standardization by age and gender using 2002 as the reference standard. Conclusion We showed that the incidence of sepsis has increased while the mortality has decreased in Taiwan. Despite the decreasing trend in sepsis mortality, the total number of sepsis mortality remains increasing due to the rapid increase in sepsis incidence.

Original languageEnglish
Pages (from-to)409-419
Number of pages11
JournalJournal of Infection
Volume75
Issue number5
DOIs
Publication statusPublished - Nov 1 2017

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Sepsis
Outcome Assessment (Health Care)
Population
Mortality
Incidence
Taiwan
Databases
Death Certificates
National Health Programs
International Classification of Diseases
Health Insurance
Hospital Emergency Service

Keywords

  • Incidence
  • Mortality
  • Nationwide database
  • Sepsis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people. / Lee, Chien Chang; Yo, Chia Hung; Lee, Meng tse Gabriel; Tsai, Kuang Chau; Lee, Shih Hao; Chen, Yueh Sheng; Lee, Wan Chien; Hsu, Tzu Chun; Lee, Sie Hue; Chang, Shy Shin.

In: Journal of Infection, Vol. 75, No. 5, 01.11.2017, p. 409-419.

Research output: Contribution to journalArticle

Lee, CC, Yo, CH, Lee, MTG, Tsai, KC, Lee, SH, Chen, YS, Lee, WC, Hsu, TC, Lee, SH & Chang, SS 2017, 'Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people', Journal of Infection, vol. 75, no. 5, pp. 409-419. https://doi.org/10.1016/j.jinf.2017.08.012
Lee, Chien Chang ; Yo, Chia Hung ; Lee, Meng tse Gabriel ; Tsai, Kuang Chau ; Lee, Shih Hao ; Chen, Yueh Sheng ; Lee, Wan Chien ; Hsu, Tzu Chun ; Lee, Sie Hue ; Chang, Shy Shin. / Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people. In: Journal of Infection. 2017 ; Vol. 75, No. 5. pp. 409-419.
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abstract = "Objectives To determine the trend of incidence and outcome of sepsis based on a nationwide administrative database. Methods We analyzed the incidence and mortality of both emergency department treated and hospital treated sepsis from 2002 through 2012 using the entire health insurance claims data of Taiwan. The national health insurance covers 99{\%} of residents in Taiwan. Sepsis patients were identified using a set of validated ICD-9CM codes conforming to the sepsis-3 definition. The 30-day all-cause mortality was verified by linked death certificate database. Results During the 11-year study period, a total of 1,259,578 episodes of sepsis was identified. The mean incidence rate was 639 per 100,000 person-years, increasing from 637.8/100,000 persons in 2002 to 772.1/100,000 persons in 2012 (annual increase: 1.9{\%}). The mortality rate, however, has decreased from 27.8{\%} in 2002 to 22.8{\%} in 2012 (annual decrease: 0.45{\%}). The trend of incidence and mortality did not change after standardization by age and gender using 2002 as the reference standard. Conclusion We showed that the incidence of sepsis has increased while the mortality has decreased in Taiwan. Despite the decreasing trend in sepsis mortality, the total number of sepsis mortality remains increasing due to the rapid increase in sepsis incidence.",
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