Acute Crit Care.  2019 Feb;34(1):30-37. 10.4266/acc.2018.00318.

Application of Sepsis-3 Criteria to Korean Patients with Critical Illnesses

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
  • 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea.
  • 3Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Anesthesiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
  • 7Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.
  • 8Department of Anesthesia and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 9Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 10Department of Software Convergence, Seoul Women's University, Seoul, Korea.
  • 11Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr

Abstract

BACKGROUND
The 2016 Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM) task force for Sepsis-3 devised new definitions for sepsis, sepsis with organ dysfunction and septic shock. Although Sepsis-3 was data-driven, evidence-based approach, East Asian descents comprised minor portions of the project population.
METHODS
We selected Korean participants from the fever and antipyretics in critically ill patients evaluation (FACE) study, a joint study between Korea and Japan. We calculated the concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria and evaluated mortality rates of sepsis, sepsis with organ dysfunction, and septic shock by Sepsis-3 criteria using the selected data.
RESULTS
Korean participants of the FACE study were 913 (383 with sepsis and 530 without sepsis by Sepsis-2 criteria). The concordance rate for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria was 55.4%. The intensive care unit (ICU) and 28-day mortality rates of sepsis, sepsis with organ dysfunction, and septic shock patients according to Sepsis-3 criteria were 26.2% and 31.0%, 27.5% and 32.5%, and 40.8% and 43.4%, respectively. The quick Sequential Organ Failure Assessment (qSOFA) was inferior not only to SOFA but also to systemic inflammatory response syndrome (SIRS) for predicting ICU and 28-day mortality.
CONCLUSIONS
The concordance rates for sepsis diagnosis between Sepsis-2 and Sepsis-3 criteria were low. Mortality rate for septic shock in Koreans was consistent with estimates made by the 2016 SCCM/ESICM task force. SOFA and SIRS were better than qSOFA for predicting ICU and 28-day mortality in Korean ICU patients.

Keyword

intensive care units; organ dysfunction; Sepsis; Sepsis-3; septic shock

MeSH Terms

Advisory Committees
Antipyretics
Asian Continental Ancestry Group
Critical Care
Critical Illness*
Diagnosis
Fever
Humans
Intensive Care Units
Japan
Joints
Korea
Mortality
Sepsis
Shock, Septic
Systemic Inflammatory Response Syndrome
Antipyretics
Full Text Links
  • ACC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error