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Original Research: CRITICAL CARE MEDICINE |

Epidemiologic Trend of Severe Sepsis in Taiwan From 1997 Through 2006

Hsiu-Nien Shen, MD; Chin-Li Lu, MS; Hsi-Hsing Yang, MD
Author and Funding Information

From the Department of Intensive Care Medicine (Drs Shen and Yang), and Medical Research (Ms Lu), Chi Mei Medical Center, Tainan, Taiwan.

Correspondence to: Chin-Li Lu, MS, Department of Medical Research, Chi Mei Medical Center, No. 901 Chung Hwa Rd, Yong Kang City, Tainan, Taiwan; e-mail: chinli.lu@gmail.com


Funding/Support: The study was performed in Chi Mei Medical Center and supported by grant CMFHR9753 from the hospital.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(2):298-304. doi:10.1378/chest.09-2205
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Background:  The epidemiologic data of severe sepsis are limited in developing countries. Among patients, the contribution of subsequent severe sepsis episodes to the disease burden is unclear.

Methods:  We analyzed the hospitalization claims data of a nationally representative sample of 200,000 people, approximately 1% of the population, enrolled in the Taiwan National Health Insurance program. We identified first and subsequent episodes of severe sepsis hospital admissions from 1997 to 2006 based on International Classification of Diseases, 9th ed., Clinical Modification codes for infections and acute organ dysfunction.

Results:  During the 10-year period, we identified 5,258 patients having 7,531 hospitalizations for severe sepsis in the study cohort. The age-standardized annual incidence rates of first episodes increased by 1.6-fold from 135 per 100,000 in 1997 to 217 per 100,000 in 2006, with an annual percent change of 3.9% (95% CI, 2.3%-5.5%). Although the proportion of patients with multiorgan (≥ 2) dysfunctions increased from 11.7% in 1997 to 27.6% in 2006, the hospital mortality changed little, averaging 30.8%. Among survivors, 34.4% developed at least one subsequent severe sepsis episode, which contributed 30.2% to the disease burden in 10 years.

Conclusions:  The incidence and disease severity of severe sepsis in Taiwan are increasing. One-third of the survivors developed at least one subsequent episode, which contributed substantially to the disease burden over time.

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