Chest
Original ResearchCritical Care MedicineEpidemiologic Trend of Severe Sepsis in Taiwan From 1997 Through 2006
Section snippets
Database
The National Health Insurance (NHI) system is compulsory and covers all citizens except prison inmates. Patients were drawn from the NHI Research Database (NHIRD),24 which was released for research purposes by the National Health Research Institutes, Taipei, Taiwan. The NHIRD covers nearly all (99%) inpatient and outpatient claims for its population of > 22 million, is one of the largest and most comprehensive databases in the world, and has been used extensively in various studies.25, 26, 27
Demographics and Clinical Characteristics
Of the 201,657 hospitalizations, including 18,092 ICU admissions, during the 10-year period, we identified 5,258 patients having 7,531 hospitalizations (average, 3.7 cases per 100 hospitalizations), including 3,560 ICU admissions (average, 19.7 cases per 100 ICU admissions) for severe sepsis. Of the 5,258 patients included in the study, 1,618 (30.8%) died during their first-episode admissions. Of the remaining 3,640 patients, 1,257 (34.4%) had one or more readmissions for subsequent episodes of
Discussion
In this study, we found significant transitions in the demographics of patients with severe sepsis and in their differential distribution of comorbidities, infection sites, and organ dysfunctions over time. These changes, also present in developed countries,4, 13 are influential for planning health services and resource allocations. More importantly, approximately one-third of the patients surviving their first episode of severe sepsis developed at least one subsequent episode, which will
Acknowledgments
Author contributions: Dr Shen: contributed to the study design, obtaining funding, data mining and processing, statistical analysis, drafting of the initial manuscript and revision for important content.
Ms Lu: contributed to the study design, data mining and processing, analysis and interpretation of results, and revision of the manuscript for important content.
Dr Yang: contributed to the chart reviews and revision of the manuscript for important content.
Other contributions: The study was based
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Funding/Support: The study was performed in Chi Mei Medical Center and supported by grant CMFHR9753 from the hospital.
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