Principles of Critical Care > Part V. Infectious Disorders > Chapter 46. Sepsis with Acute Organ Dysfunction E. Wesley Ely, Richert E. Goyette

Key Points

"Sepsis with acute organ dysfunction (severe sepsis) is common and frequently fatal and represents a significant health care burden. The incidence and associated mortality and morbidity rates of severe sepsis are commonly underestimated. This is a function of a number of factors. Severe sepsis is not generally reported as a primary diagnosis. For example, although steps are underway to address this issue, the most recent edition of the International Classification of Diseases, Ninth Revision, Clinical Modification lacks a diagnostic code for severe sepsis. Instead, severe sepsis is often coded as a complication of another disorder (e.g., cancer or pneumonia). Several recent publications have evaluated the epidemiology of severe sepsis in the United States.^1,2 They have estimated that the annual incidence of severe sepsis in the United States is in the range of 240 to 300 cases per 100,000 population. Further, in 2003, there were approximately 750,000 cases of sepsis in the United States. In Europe, the incidence of severe sepsis exceeds 200,000 annually.³ Reported mortality rates in patients with severe sepsis range from 28% to 50% or higher.^1,4 Thus, in the United States and Europe, at least 700 to 1300 patients die daily from severe sepsis. Patients with severe sepsis account for annual health care expenditures in excess of $16 billion in the United States and £5.2 billion in Europe.^1,3..."