Skip to main content
Download PDF

Epidemiology of sepsis in Beijing from 2012 to 2018: analysis of hospital homepage databases derived from the Beijing Public Health System

BMC Public Health volume 22, Article number: 2237 (2022) Cite this article

Abstract

Background

We aimed to evaluate the epidemiology of sepsis in secondary and tertiary hospitals in Beijing, China between 2012 and 2018 using information derived from the Beijing Public Health System.

Methods

The Beijing Public Health System accessed hospital homepage databases and identify patients who diagnosed sepsis or associated condition according to the International Classification of Diseases, 10th Edition, Clinical Modification codes. There are 125 hospitals involved in this study, including 61 secondary hospitals, accounting for 49.2%, and 63 tertiary hospitals, accounting for 50.8%. Patients were stratified by age as minors (0–17 years old), adults (18–64 years old), seniors (65–84 years old), and the elderly (≥ 85 years old). Patient’s demographic information, treatments, outcomes, and all-cause hospitalization cost were evaluated.

Results

This study involved 8,597 patients. Patients treated in tertiary hospitals or received blood transfusion decreased with age, while patients who were male, received ventilation, or took Traditional Chinese Medicine, and in-hospital mortality and hospitalization cost, increased with age. There were 2,729 (31.7%) deaths in this study. A slight increase in in-hospital mortality occurred from 2012 to 2018. Median hospitalization cost for all patients was ¥29,453 (15,011, 65,237). Hospitalization cost showed no significant change from 2012 to 2016, but increased in 2017 and 2018.

Conclusion

Sepsis is associated with high mortality and cost. From 2012 to 2018, in-hospital mortality and hospitalization cost of sepsis in Beijing increased significantly with age, and slightly by year.

Peer Review reports

Background

Sepsis is associated with high morbidity and mortality. Worldwide, sepsis represents a major health concern in patients in intensive care units (ICU). Notably, the incidence of sepsis has risen in the last decades [1,2,3], causing a substantial clinical and economic burden to healthcare systems [4, 5]. Globally, in 2012, 29.5% of patients admitted to the ICU experienced sepsis and ICU mortality rates in patients with sepsis were 29.8% [6, 7], while hospital mortality rates were 35.3% [6]. In 2017, the Global Burden of Diseases, Injuries and Risk Factors Study reported 49 million cases of sepsis and 11 million sepsis-related deaths, which accounted for approximately 19.7% of all deaths worldwide [8]. In 2015, the standardized sepsis-related mortality rate in China was 66.7 deaths per 100,000 population, resulting in an estimated 1 million sepsis-related deaths [9]. Long-term epidemiological investigations on sepsis in China are limited. The objective of this study was to evaluate the epidemiology of sepsis in secondary and tertiary hospitals in Beijing between 2012 and 2018 using information derived from the Beijing Public Health System. Comparisons of the epidemiological characteristics, hospitalization and prognosis of sepsis among minors, adults and the elderly will help hospitals provide medical services that optimize length of stay, patient outcomes, and cost of hospitalization.

Methods

Ethics declarations

This study was approved by Bioethics Committee of our hospital and The informed consent was waived by Bioethics Committee of Beijing Friendship hospital. (No: 2021-P2-121-01).

Data source

The Beijing Public Health System was used to access hospital homepage databases and identify patients admitted to secondary and tertiary hospitals in Beijing between 2012 and 2018 who had a diagnosis of sepsis or associated condition according to a primary International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM) code (Table 1). There are 125 hospitals involved in this study, including 61 secondary hospitals, accounting for 49.2%, and 63 tertiary hospitals, accounting for 50.8%. Patients admitted to military and private hospitals were excluded.

Table 1 Primary ICD-10-CM code
Full size table

Patient selection was refined using secondary ICD-10-CM codes that aligned with the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) recommendation that sepsis be defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection [10] (Table 2).

Table 2 Secondary ICD-10-CM code
Full size table

Data screening and database establishment

A total of 69,384 patients with a diagnosis of sepsis or associated condition according to a primary ICD-10-CM code were identified, 9,232 patients had a secondary ICD-10-CM code, and 36 patients with incomplete, incorrect, invalid or duplicate data were excluded. Of the 69,384 patients with a diagnosis of sepsis or associated condition according to a primary ICD-10-CM code, 404 patients were discharged and readmitted to the same hospital within a few days, once or on multiple occasions, during which they had a secondary ICD-10-CM code. For the purpose of this study, these patients were considered to have received continuous treatment. After consolidating the data for these patients into a single hospitalization, the final dataset included information for 8,597 patients (Fig. 1).

Fig. 1
figure 1

Flowchart of patient selection. ICD-10-CM: International Classification of Diseases, 10th Edition, Clinical Modification

Full size image

Data collection

Extracted data included patient’s demographic information (gender, age, year of hospitalization, hospital level), treatments (blood transfusion, ventilation, Traditional Chinese Medicine [TCM]), outcomes, and all-cause hospitalization cost. For patients who received continuous treatment, demographic data were reported based on the last hospitalization, and variables such as length of hospital stay, treatment and costs were cumulative across hospitalizations. Patients were stratified by age as minors (0-17 years old), adults (18-64 years old), seniors (65-84 years old) and the elderly (≥85 years old).

Statistical analysis

Statistical analysis was performed using SPSS v25.0 (IBM, America), Categorical variables are reported as frequency (n) and percentage (%), and were compared with the Chi-square test [11]. Normally distributed continuous variables are reported as mean ± standard deviation, and were compared with the T-test or variance analysis. Abnormally distributed continuous variables are reported as median (25, 75 percentiles) [M (QL, QU)], and were compared with the Wilcoxon/Kruskal-Wallis nonparametric test. Temporal trends are presented as line graphs. p<0.05 was considered statistically significant.

Results

Demographic characteristics and general information

This study involved 8,597 patients, including 4,992 males (58.1%) and 3,605 females (41.9%) with a median age of 60 (50, 81) years. 7,617 (88.6%) patients were admitted to tertiary hospitals, 2,994 (34.8%) patients received blood transfusion, 2,286 (26.6%) patients received ventilation for a median 117 (33, 282) hours, and 4,677 (54.4%) patients were treated with TCM. Median length of hospital stay was 11 (6, 18) days. 2,729 (31.7%) patients died in hospital.

Clinical characteristics of age groups

Patients were stratified by age as minors (0-17 years old; n=935, 10.9%), adults (18-64 years old; n=2,848, 33.1%), seniors (65-84 years old; n=3,526, 41.0%) and the elderly (≥85 years old; n=1,288, 15.0%). The demographic and clinical characteristics of patients stratified by age are summarized in Table 3. Except for platelet volume received during blood transfusion, there were significant differences in the demographic and clinical characteristics of all patients across age categories, and these variables showed a significant linear relationship with age. Specifically, the proportion of patients treated in tertiary hospitals or who received blood transfusion decreased with age, while the proportion of patients who were male, received ventilation, or took TCM, and in-hospital mortality and hospitalization cost, increased with age.

Table 3 Demographic and clinical characteristics of included patients stratified by age
Full size table

Pairwise comparisons showed significant differences in gender between seniors and the elderly; hospital grade, mechanical ventilation and in-hospital mortality between all age groups; blood transfusion and the use of TCM between minors and adults; red blood cell volume received during blood transfusion between minors and the other age groups and adults and the elderly; and plasma volume received during blood transfusion between minors and the other age groups. There were significant differences between all age groups in ventilation time, except between minors and adults and seniors and the elderly; length of hospital stay, except between adults and seniors and seniors and the elderly; and hospitalization cost, except between seniors and the elderly.

Comparison of in-hospital mortality across age groups

There were 2,729 (31.7%) in-hospital deaths from sepsis in this study. There was a significant difference in in-hospital mortality across hospital type, with 594 deaths (60.6%) occurring in secondary hospitals, and 2,135 deaths (28.0%) occurring in tertiary hospitals (χ2=425.443, p<0.001). In-hospital mortality was 4.8% (45/935), 17.4% (496/2,848), 40.8% (1,440/3,526), and 58.1% (748/1,288) for minors, adults, seniors and the elderly, respectively. There were significant differences in in-hospital mortality across age categories (χ2=1,129.596, p<0.001), and in-hospital mortality showed a significant linear relationship with age (χ2=1,109.469, p<0.001; R=0.359, p<0.001), indicating in-hospital mortality increased with age (Table 3, Fig. 2).

Fig. 2
figure 2

In-hospital mortality stratified by age

Full size image

Trends in in-hospital mortality from 2012 to 2018

In-hospital mortality was 31.3% (115/367), 32.9% (197/598), 21.2% (255/1204), 31.8% (553/1741), 30.2% (597/1975), 37.4% (725/1941) and 37.2% (287/771) for each consecutive year from 2012 through 2018, respectively. There were significant differences in in-hospital mortality across the years (χ2=103.401, p<0.001) and in-hospital mortality showed a significant linear relationship with time (χ2=40.909, p<0.001; R=0.069, p<0.001), indicating in-hospital mortality increased by year (Fig. 3).

Fig. 3
figure 3

Trends in in-hospital mortality stratified by age from 2012 to 2018

Full size image

Trends in hospitalization costs across age groups from 2012 to 2018

Median hospitalization cost for all patients included in this study was ¥29,453 (15,011, 65,237). There was no significant difference in median hospitalization cost across hospital type (secondary hospital, ¥31942.9 [14052.2, 69776.2]; tertiary hospital, ¥29250.3 [15072.6, 64939.8]; p<0.944). There were significant differences in median hospitalization cost for minors and adults, but not for seniors and the elderly (H=478.803, p<0.001) (Table 3, Fig. 4). There were significant differences in median hospitalization cost for all patients across the years (H=68.905, P<0.001). Pairwise comparison showed significant differences in median hospitalization cost for all patients between 2014 and 2017, 2014 and 2018, 2015 and 2017, 2015 and 2018, 2016 and 2017, and 2016 and 2018 (p<0.001). There was a numerical decrease in median hospitalization cost between 2012 and 2016, and a numerical increase between 2017 and 2018 (Table 3, Fig. 5).

Fig. 4
figure 4

Box-plot of hospitalization cost stratified by age. CNY: Chinese Yuan

Full size image
Fig. 5
figure 5

Median hospitalization cost of all patients by year from 2012 to 2018. CNY: Chinese Yuan

Full size image

Discussion

This study used the Beijing Public Health System to access hospital homepage databases and to evaluate the epidemiology of sepsis in secondary and tertiary hospitals in Beijing between 2012 and 2018. The study included patients who had a diagnosis of sepsis or an associated condition according to ICD-10-CM codes. The median age of the study population was 60 (50, 81) years and 58.1 % were males. This age and gender distribution is similar to other studies investigating the epidemiology of sepsis in China [12]. Our findings showed that the proportion of patients with sepsis treated in tertiary hospitals or who received blood transfusion decreased with age, while the proportion of patients who were male, received ventilation or took TCM, and in-hospital mortality and hospitalization cost, increased with age.

The proportion of patients with sepsis treated in tertiary hospitals decreased with age from 99.9% of minors to 78.1% of the elderly. This may be related to different expectations of patients and their families around outcomes. Younger patients, especially minors, are expected to have a good prognosis. The prognosis for elderly patients may not be so good, so patients and families may choose the less invasive treatments provided by secondary hospitals, or palliative care.

A meta-analysis indicated that TCM combined with conventional treatment can improve the prognosis of patients with sepsis [13,14,15]. Statistics show the number of hospital beds in Beijing for patients is 6.85 per 1,000 population [16], while the number of hospital beds for patients treated with TCM is 10.48 per 10,000 population [17], accounting for only one sixth of the total. In this study, 54.4% of patients received TCM; thus, it can be inferred that many physicians in hospitals providing Western medical services also used TCM, and a combination of TCM and Western medicine was commonly used when treating sepsis.

A previous study showed the 77.4% of patients with sepsis in the ICU of a tertiary hospital in China were on mechanical ventilation [18]. One epidemiological study in Beijing showed that the 13.8% of hospitalized patients with sepsis were admitted to the ICU [12]. In the present study, ventilation was only used in 26.6% of patients, most often in elderly patients. Taken together, these data suggest that a large number of patients with sepsis in China are treated in general wards without mechanical ventilation. Critical care physicians may not be sufficiently aware of sepsis, which may lead to inappropriate clinical decision-making and an increase in sepsis-related mortality.

In previous studies, mortality rates for sepsis and severe sepsis in developed countries were 17% and 26%-33.2%, respectively [19, 20]. In low- and middle-income countries, mortality rates for sepsis and severe sepsis were 21.9%-47.3%, and reached 45.6%-52.2% for septic shock [21,22,23,24,25]. In a multicenter study in Asia, in 2009, the ICU mortality rate for severe sepsis was 44.5% [26]. In China, in 2014 and 2015, ICU mortality rates for sepsis and septic shock were 13.1% and 39.0%, respectively, and the hospital mortality rate for sepsis was 33.0% [18]. Similarly, in the present study, the in-hospital mortality rate for sepsis was 31.7%, and increased with age from 4.8% in minors to 58.1% in the elderly. Consistent with these findings, a multicenter study conducted in 2019 in southwest China involving 10,598 children (aged 29 days -18 years) reported the in-hospital mortality rate for severe sepsis and septic shock was 18.8% [27], and a retrospective cohort study of patients with sepsis admitted to public hospitals in Yuetan Subdistrict, Beijing between 2012 and 2014 showed a significant increase in sepsis mortality from 2.4% in patients < 50 years to 30.7% in patients > 90 years [12]. Sepsis mortality depends on factors such as age, race, gender, comorbidities, and degree of organ dysfunction [28]. In China, sepsis mortality is expected to increase with the move towards an aging society and the higher prevalence of comorbidities in elderly individuals.

Globally, mortality associated with sepsis is decreasing by year. Severe sepsis 28-day mortality decreased from 46.9% in 1991-1995 to 29% in 2006-2009 in the US [20], and from 56% in 1993 to 35% in 2001 in France [29]. Absolute mortality in severe sepsis decreased from 35.0% in 2000 to 18.4% in 2012 in ICUs in Australia and New Zealand [30]. Hospital mortality fell from 23.7% in 2008 to 19.7% in 2012 in patients with sepsis in all acute-care hospitals in Catalonia [31]. In contrast, the present study showed an increase in in-hospital mortality in patients with sepsis in China. Long-term epidemiological investigations of sepsis-related mortality in China are limited. However, two multicenter, prospective cohort studies reported that in- hospital mortality in patients with sepsis in China was 33.5% in 2009 [32] and 33.0% in 2014-2015 [18]. The disparate findings between studies may be explained by 1) the use of different definitions of sepsis. Our study used Sepsis-3.0, while the prior studies used Sepsis1.0 or 2.0 [33]; 2) Guidelines for sepsis have evolved since the prior studies were performed [21, 22, 34]; and 3) rates of mechanical ventilation use in sepsis vary, which may influence sepsis-related mortality.

The cost of sepsis may reflect factors such as the Gross Domestic Product (GDP), regional economy, and public opinion of health. In the US, between 1979 and 2000, the cost of sepsis was an estimated $50,000 per patient, resulting in an annual economic burden of $17 billion [35]. Between 2003 and 2007, the economic burden of sepsis in the US increased from $15.4 billion to $24.3 billion [36]. In the UK, in 2002, the cost of sepsis was £25,000 per patient [7]. In contrast, in India, in 2005, the cost of care for sepsis in the ICU was approximately $200 a day [37]. The cost of sepsis in China is not as high as that of developed countries. In 2007, the average ICU cost for sepsis in China was $11,390 per patient, or $502 per patient per day [38]. In our study, median hospitalization cost for all patients was ¥29,453 (15,011, 65,237), and costs increased with age, reaching ¥41,215 (18,991, 88,259) in the elderly. Hospitalization cost showed no significant change from 2012 to 2016, but increased in 2017 and 2018.

Strengths and limitations

Currently, high-quality epidemiological studies on sepsis in China include data collected over 2-20 months [9, 12, 18, 27, 32]. To the authors’ knowledge, the present study is the longest (7 years) epidemiological investigation of sepsis in secondary and tertiary hospitals in Beijing, using information from 2012-2018 that was derived from the Beijing Public Health System. Information was collated and manually screened to ensure patients with multiple hospitalizations were not overrepresented, which may have biased our findings towards reduced length of hospital stay, in-hospital mortality, and hospitalization cost. The data used in this study were easy and cost-effective to access, and findings provide important information for clinicians and policy makers.

Despite, these strengths, the study was associated with several limitations. First, the data informing this study were acquired from hospitals in Beijing, which may restrict the generalizability of our results across other regions, including those with a lower level of economic development and fewer medical resources. Second, sources of error in retrospective studies include incomplete or missing data. Consequently, the clinical and economic burden of sepsis in China may be more serious than expected; however, our results can be used as a reference for future studies.

Conclusions

Sepsis is associated with high mortality and cost. From 2012 to 2018, the in-hospital mortality and cost of sepsis in Beijing was higher in older patients and increased by year.

Availability of data and materials

The datasets generated and analyzed during the present study are available from the corresponding author on reasonable request.

References

  1. Walkey AJ, Lagu T, Lindenauer PK. Trends in sepsis and infection sources in the United States. A population-based study. Ann Am Thorac Soc. 2015;12:216–20.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kumar G, Kumar N, Taneja A, Kaleekal T, Tarima S, McGinley E, et al. Nationwide trends of severe sepsis in the 21st century (2000–2007). Chest. 2011;140:1223–31.

    Article  PubMed  Google Scholar 

  3. Elixhauser A, Friedman B, Stranges E. Septicemia in U.S. Hospitals, 2009. 2011 Oct. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville: Agency for Healthcare Research and Quality (US); 2006. Statistical Brief #122.

  4. Torio CM, Moore BJ. National inpatient hospital costs: The most expensive conditions by payer, 2013. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville: Agency for Healthcare Research and Quality (US); 2006.

    Google Scholar 

  5. Torio CM, Andrews RM. National inpatient hospital costs: The most expensive conditions by payer, 2011. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville: Agency for Healthcare Research and Quality (US); 2006.

    Google Scholar 

  6. Sakr Y, Jaschinski U, Wittebole X, Szakmany T, Lipman J, Ñamendys-Silva SA, et al. Sepsis in intensive care unit patients: Worldwide data from the intensive care over nations audit. Open Forum Infect Dis. 2018;5:ofy313.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, et al. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34:344–53.

    Article  PubMed  Google Scholar 

  8. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395:200–11.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Weng L, Zeng XY, Yin P, Wang LJ, Wang CY, Jiang W, et al. Sepsis-related mortality in China: a descriptive analysis. Intensive Care Med. 2018;44:1071–80.

    Article  PubMed  Google Scholar 

  10. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). Jama. 2016;315:801–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Lee SW. Methods for testing statistical differences between groups in medical research: statistical standard and guideline of Life Cycle Committee. Life Cycle. 2022;2:e1.

    Article  Google Scholar 

  12. Zhou J, Tian H, Du X, Xi X, An Y, Duan M, et al. Population-based epidemiology of sepsis in a subdistrict of beijing. Crit Care Med. 2017;45:1168–76.

    Article  PubMed  Google Scholar 

  13. Li C, Wang P, Zhang L, Li M, Lei X, Liu S, et al. Efficacy and safety of xuebijing injection (a chinese patent) for sepsis: A meta-analysis of randomized controlled trials. J Ethnopharmacol. 2018;224:512–21.

    Article  PubMed  Google Scholar 

  14. Xiao SH, Luo L, Liu XH, Zhou YM, Liu HM, Huang ZF. Curative efficacy and safety of traditional chinese medicine xuebijing injections combined with ulinastatin for treating sepsis in the chinese population: A meta-analysis. Medicine (Baltimore). 2018;97:e10971.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Liang X, Zhou M, Ge XY, Li CB, Fang SP, Tang L, et al. Efficacy of traditional Chinese medicine on sepsis: a systematic review and Meta-Analysis. Int J Clin Exp Med. 2015;8:20024–34.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Qin P, Wang XR. Current situation analysis of health human resources of comprehensive hospital in beijing. J China Med Univ. 2014;43:538–41.

    Google Scholar 

  17. Wang XR, Guo YW, Bai Q, Huang LY, Li S, Yang Y. Analysis on the fairness of the allocation of TCM hospitals in 31 provinces of China in 2016. China Med Herald. 2019;16:174–7.

    Google Scholar 

  18. Wang M, Jiang L, Zhu B, Li W, Du B, Kang Y, et al. The prevalence, risk factors, and outcomes of sepsis in critically ill patients in china: A multicenter prospective cohort study. Front Med (Lausanne). 2020;7:593808.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193:259–72.

    Article  CAS  PubMed  Google Scholar 

  20. Stevenson EK, Rubenstein AR, Radin GT, Wiener RS, Walkey AJ. Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis*. Crit Care Med. 2014;42:625–31.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Singh K, Hariharan S, Ventour D, Chen DR, Merritt-Charles LG, Sookwah M, et al. Epidemiology and management trends of patients with sepsis and septic shock in the intensive care unit: A prospective trial in the caribbean. Cureus. 2020;12:e10980.

    PubMed  PubMed Central  Google Scholar 

  22. Cecconi M, Evans L, Levy M, Rhodes A. Sepsis and septic shock. Lancet. 2018;392:75–87.

    Article  PubMed  Google Scholar 

  23. Paary TT, Kalaiselvan MS, Renuka MK, Arunkumar AS. Clinical profile and outcome of patients with severe sepsis treated in an intensive care unit in India. Ceylon Med J. 2016;61:181–4.

    Article  CAS  PubMed  Google Scholar 

  24. Rodríguez F, Barrera L, De La Rosa G, Dennis R, Dueñas C, Granados M, et al. The epidemiology of sepsis in Colombia: a prospective multicenter cohort study in ten university hospitals. Crit Care Med. 2011;39:1675–82.

    Article  PubMed  Google Scholar 

  25. Silva E, Pedro Mde A, Sogayar AC, Mohovic T, Silva CL, Janiszewski M, et al. Brazilian sepsis epidemiological study (bases study). Crit Care. 2004;8:R251-260.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Phua J, Koh Y, Du B, Tang YQ, Divatia JV, Tan CC, et al. Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. Bmj. 2011;342:d3245.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Xiao C, Wang S, Fang F, Xu F, Xiao S, Li B, et al. Epidemiology of pediatric severe sepsis in main picu centers in southwest china. Pediatr Crit Care Med. 2019;20:1118–25.

    PubMed  Google Scholar 

  28. Annane D, Bellissant E, Cavaillon JM. Septic shock. Lancet. 2005;365:63–78.

    Article  CAS  PubMed  Google Scholar 

  29. Brun-Buisson C, Meshaka P, Pinton P, Vallet B. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med. 2004;30:580–8.

    Article  CAS  PubMed  Google Scholar 

  30. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000–2012. Jama. 2014;311:1308–16.

    Article  CAS  PubMed  Google Scholar 

  31. Yébenes JC, Ruiz-Rodriguez JC, Ferrer R, Clèries M, Bosch A, Lorencio C, et al. Epidemiology of sepsis in Catalonia: analysis of incidence and outcomes in a European setting. Ann Intensive Care. 2017;7:19.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zhou J, Qian C, Zhao M, Yu X, Kang Y, Ma X, et al. Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China. PLoS One. 2014;9:e107181.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Tian H, Zhou J, Du B. Epidemiological comparison between the new and the old diagnostic criteria for sepsis: a retrospective cohort study based on the database of Beijing Public Health Information System. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019;31:1072–7.

    PubMed  Google Scholar 

  34. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6:223–30.

    Article  PubMed  Google Scholar 

  35. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546–54.

    Article  PubMed  Google Scholar 

  36. Lagu T, Rothberg MB, Shieh MS, Pekow PS, Steingrub JS, Lindenauer PK. Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. J Crit Care. 2012;40:754–61.

    Google Scholar 

  37. Kulkarni AP, Divatia JV. A prospective audit of costs of intensive care in cancer patients in India. Indian J Crit Care Med. 2013;17:292–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Cheng B, Xie G, Yao S, Wu X, Guo Q, Gu M, et al. Epidemiology of severe sepsis in critically ill surgical patients in ten university hospitals in China. Crit Care Med. 2007;35:2538–46.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the staff of Beijing Friendship Hospital for all their help and support with clinical data collection.

Funding

This work was supported by the Beijing Key Clinical Specialty Excellence Project.

Author information

Author notes

  1. Dong-chen Guo and Hai-zhou Zhuang contributed equally to this work and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong’an Road, Xicheng District, 100050, Beijing, China

    Dong-chen Guo, Hai-zhou Zhuang, Jin Lin, De-yuan Zhi & Mei-li Duan

Authors
  1. Dong-chen Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hai-zhou Zhuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jin Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. De-yuan Zhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mei-li Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: Dong-chen Guo, Jin Lin, Mei-li Duan; Methodology: Dong-chen Guo, Jin Lin; Formal analysis and investigation: Dong-chen Guo; Writing - original draft preparation: Dong-chen Guo, Hai-zhou Zhuang; Writing - review and editing: Jin Lin, De-yuan Zhi, Mei-li Duan; Funding acquisition: De-yuan Zhi, Mei-li Duan; Resources: Mei-li Duan; Supervision: Mei-li Duan. The author(s) read and approved the final manuscript.

Corresponding author

Correspondence to Mei-li Duan.

Ethics declarations

Ethics approval and consent to participate

This study was approved by Bioethics Committee of Beijing Friendship hospital (No: 2021-P2-121-01). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The informed consent was waived by Bioethics Committee of Beijing Friendship hospital.

Consent for publication

Not applicable.

Competing interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guo, Dc., Zhuang, Hz., Lin, J. et al. Epidemiology of sepsis in Beijing from 2012 to 2018: analysis of hospital homepage databases derived from the Beijing Public Health System. BMC Public Health 22, 2237 (2022). https://doi.org/10.1186/s12889-022-14725-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12889-022-14725-1

Keywords

BMC Public Health

ISSN: 1471-2458

Contact us