Table 1 Study and population characteristics: cohort studies
From: Community-onset sepsis and its public health burden: a systematic review
| Study ID year [country] | Study characteristics | Population characteristics | Case identification and data source | Exposure and follow-up |
|---|---|---|---|---|
| Esteban 2007 [46] Spain | Design: prospective | Case definition and criteria used: ACCP/SCCM definitions μ | Case report forms | Exposure: Not defined |
| Study setting: ICU, hospital ward | Criteria for COS: 83% sepsis patients had a community-acquired infection (no other details given) | FU: March 1, 2003 to June 30, 2003 | ||
| Geographic scope: city/municipal | Inclusion criteria: Consecutively admitted patients (age≥18 years) | FU duration: 4 months | ||
| Recruitment years: March 1, 2003 to June 30, 2003 | Description (n sample size): 15,852 (includes n=702 non-severe sepsis cases) | |||
| Ginde 2013 [47] The USA | Design: retrospective | Case definition and criteria used: Severe sepsis as concurrent bacterial or fungal infection plus acute organ dysfunction using ICD-9-CM codes (995.92) for infection and acute organ dysfunction | Annual survey of ED visits conducted by the National Centre for Health Statistics (associated with U.S. non-institutional, general and short stay hospitals) | Exposure: Age, nursing home residence |
| Study setting: nursing residence, community-living, ED | ||||
| FU: 2005 to 2009 | ||||
| Criteria for COS: patients admitted to ED for severe sepsis | FU duration: 5 years | |||
| Geographic scope: Nationwide | Inclusion criteria: adults (≥18 years) who visited ED (with or without infection other than sepsis) | |||
| Recruitment years: 2005–2009 | Description (n sample size): a nationally representative survey of all ED visits of adults (age ≥ 18 years) in 2005–2009 (n=87,500,000) | |||
| Harrison 2006 [11] The UK | Design: retrospective | Case definition and criteria used: severe sepsis - infection plus ≥3 SIRS criteria and ≥1 organ dysfunction during the 24-hour period | The Case Mix Programme Database containing data on demographics, case mix, outcome and activity for admissions. Patient data were abstracted by trained data collectors according to precise rules and definitions | Exposure: not defined |
| Study setting: ICU and combined ICU/HDU | FU: December 2001 to January 2005 | |||
| Criteria for COS: as having severe sepsis during the first 24 hours following admission to the critical care unit | ||||
| Geographic scope: Nationwide (England, Wales, and Northern Ireland) | FU duration: 2 years (2002-2004) | |||
| Inclusion criteria: adults (≥16 years) presenting with severe sepsis within 24 hours of admission to critical care | ||||
| Description (n sample size): n=59,388 (2002), n=59,527 (2003), n=24,905 (2004) | ||||
| Recruitment years: December 1995 to January 2005 | ||||
| Henriksen 2015a [42] Denmark | Design: Prospective | Case definition and criteria used: the ACCP/SCCM criteriaμ | The hospitals’ patient administrative database and electronic patient records which were manually reviewed. | Exposure: age, sex |
| Study setting: medical ED, ICU, community-based | Criteria for COS: Patient had an infection at arrival or developed an infection during the first 48 hours after admission. | FU: September 1, 2010 to August 31, 2011 | ||
| FU duration: 12 months | ||||
| Geographic scope: city/municipal | ||||
| Inclusion criteria: adults (≥15 years) admitted to the medical ED or directly to the medical ICU | ||||
| Description (n sample size): A population-based survey of all adult | ||||
| Recruitment years: September 1, 2010, to August 31, 2011 | patients admitted to the medical ED at Odense University Hospital, Denmark (n=235,598); n=8,358 hospitalisations | |||
| Husak 2010 [48] Canada | Design: retrospective | Case definition and criteria used: Severe sepsis (including septic shock) - sepsis complicated by organ dysfunction in at least one of the six organ systems and the ICD codes | Hospital discharge abstract database | Exposure: Not defined |
| Study setting: hospital ward, ED, ICU | FU: April 1, 2004 to March 31, 2009 | |||
| Geographic scope: Nationwide | Criteria for COS: the majority (79%) of patients with sepsis were admitted via the EDs, while 12.4% were admitted directly through hospitals | FU duration: 5 years | ||
| Recruitment years: April 1, 2004 to March 31, 2009 | ||||
| Inclusion criteria: NR | ||||
| Description (n sample size): sepsis cases n=26,803 (2004-2005), n=30,587 (2008-2009), n for non-cases (all non-sepsis hospitalizations): NR | ||||
| Nygard 2014 [49] Norway | Design: prospective | Case definition and criteria used: ACCP/SCCMμ and SCCM/ESICM/ACCP/ATS/SIS | Clinical data were registered prospectively until hospital discharge or in-hospital death using predefined case report forms. Information was collected from medical records, patient charts, and the intensive care electronic monitoring system | Exposure: not defined |
| Study setting: ED, ICU, HDU, and combined ICU/HDU | FU: January 2008 to December 2008 | |||
| Criteria for COS: if they developed severe sepsis within 24 hours of admission to the primary institution | ||||
| FU duration: 12 months | ||||
| Geographic scope: city/municipal | Inclusion criteria: patients > 15 years of age hospitalized due to COS, including patients transferred from affiliated hospitals, if they developed severe sepsis within 24 hours of admission to the primary institution | |||
| Recruitment years: January 2008 - December 2008 | ||||
| Description (n sample size): total N hospitalisations (NR); n=220 severe sepsis cases; non-cases (n): 350,000 population | ||||
| Page 2015 [50] The USA | Design: retrospective | Case definition and criteria used: severe sepsis was defined using the methodology of Angus et al. identifying hospitalizations with the presence of ICD-9 discharge diagnoses for both a serious infection and organ dysfunction | Hospital discharge data from the UHC representing 300 academic and community hospitals across 42 states. Using medical record review, coders assigned discharge diagnoses for each hospitalization | Exposure: not defined |
| Study setting: NR | FU: January 1, 2012 to December 31, 2012 | |||
| Geographic scope: Nationwide | ||||
| FU duration: 12 months | ||||
| Recruitment years: January to December 2012 | Criteria for COS: Hospitalizations with an infection present at admission were subdivided into healthcare-associated (admitted from nursing facility, receiving home healthcare, or were on haemodialysis prior to admission), community acquired (from the community). Those discharged without infections at admission were categorized as hospital-acquired | |||
| Inclusion criteria: all hospital discharges from January 1, 2012 to December 31, 2012 | ||||
| Description (n sample size): n=3,355,753 hospitalisations; non-cases n (population)=NR | ||||
| Wang 2012 [36] REGARDS-sepsis cohort study The USA | Design: prospective | Case definition and criteria used: An infection plus ≥ 2 SIRS criteriaμ | Structured interviews, in-home visits, lab results, monitoring every 6 months, medical and hospital admission records (clinical and lab data) | Exposure: anthropometric, socio-demographic, dietary, and life-style factors, chronic conditions, and statin use |
| Study setting: Community-based, hospital ward, ED | Criteria for COS: cohort of community-dwelling individuals. The study focused on individuals presenting to the hospital or ED with community-acquired sepsis | |||
| Geographic scope: Nationwide | Inclusion criteria: NR | |||
| Description (n sample size): Community-dwelling ≥45 years old individuals in the US (n=30,239) | ||||
| FU: 5 February, 2003 to 31 December, 2012 | ||||
| Recruitment years: 2003-2007 | ||||
| FU duration: ≥ 7 years | ||||
| Seymour 2012 [51] The USA | Design: retrospective | Case definition and criteria used: Hospitalization with severe sepsis using the ICD-9-CM (995.92 and 785.52). Criteria for COS: pre-hospital severe sepsis | EMS reports computerized database including dispatch, demographic, clinical, and transport data for each incident. EMS data were linked to hospital discharge records | Exposure: not defined |
| Study setting: pre-hospital EMS | FU: 2000 to 2009 | |||
| FU duration: 10 years | ||||
| Geographic scope: regional (King County in Washington State) | Inclusion criteria: all adult EMS encounters involving non-trauma, non–cardiac arrest patients transported from a scene to a receiving hospital by ground ambulance | |||
| Recruitment years: 2000-2009 | Description (n sample size): all 2000-2009 EMS encounters in the area of 1.2 million residents (n=407,176) | |||
| Wang 2007 [52] The USA | Design: retrospective cohort study | Case definition and criteria used: the criteria by ACCP/SCCMμ and SCCM/ESICM/ACCP/ATS/SIS; ICD-9 codes 990.90 and 995.92 as sepsis and severe sepsis, respectively | The study used the 2001–2004 NHAMCS public use data set which is a national sample of ED and outpatient visits at hospitals across the US | Exposure: not defined |
| FU: 2001 to 2004 | ||||
| Study setting: ED | FU duration: 4 years | |||
| Geographic scope: Nationwide | Criteria for COS: patients with severe sepsis presenting to ED | |||
| Inclusion criteria: adults (≥18 years) presenting to EDs during 2001-2004 (with or without severe sepsis) | ||||
| Recruitment years: 2001-2004 | ||||
| Description (n sample size): n=113,123 ED visits (sample-based 4 years); 4-year national estimate n=331,531,000 ED visits; annual national estimate n=82,883,000 ED visits |