Sepsis in general surgery: The 2005-2007 national surgical quality improvement program perspective

Laura J. Moore, Frederick A. Moore, S. Rob Todd, Stephen L. Jones, Krista L. Turner, Barbara L. Bass

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

Objective: To document the incidence, mortality rate, and risk factors for sepsis and septic shock compared with pulmonary embolism and myocardial infarction in the general-surgery population. Design: Retrospective review. Setting: American College of Surgeons National Surgical Quality Improvement Program institutions. Patients: General-surgery patients in the 2005-2007 National Surgical Quality Improvement Program data set. Main Outcome Measures: Incidence, mortality rate, and risk factors for sepsis and septic shock. Results: Of 363 897 general-surgery patients, sepsis occurred in 8350 (2.3%), septic shock in 5977 (1.6%), pulmonary embolism in 1078 (0.3%), and myocardial infarction in 615 (0.2%). Thirty-day mortality rates for each of the groups were as follows: 5.4% for sepsis, 33.7% for septic shock, 9.1% for pulmonary embolism, and 32.0% for myocardial infarction. The septic-shock group had a greater percentage of patients older than 60 years (no sepsis, 40.2%; sepsis, 51.7%; and septic shock, 70.3%; P<.001). The need for emergency surgery resulted in more cases of sepsis (4.5%) and septic shock (4.9%) than did elective surgery (sepsis, 2.0%; septic shock, 1.2%) (P<.001). The presence of any comorbidity increased the risk of sepsis and septic shock 6-fold (odds ratio, 5.8; 95% confidence interval, 5.5-6.2) and increased the 30-day mortality rate 22-fold (odds ratio, 21.8; 95% confidence interval, 17.6-26.9). Conclusions: The incidences of sepsis and septic shock exceed those of pulmonary embolism and myocardial infarction. The risk factors for mortality include age older than 60 years, the need for emergency surgery, and the presence of any comorbidity. This study emphasizes the need for early recognition of patients at risk via aggressive screening and the rapid implementation of evidence-based guidelines.

Original languageEnglish (US)
Pages (from-to)695-700
Number of pages6
JournalArchives of Surgery
Volume145
Issue number7
DOIs
StatePublished - Jul 2010

ASJC Scopus subject areas

  • Surgery

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