Abstract
BackgroundPostoperative sepsis is a major type of sepsis. Sociodemographic characteristics, incidence trends, surgical procedures, comorbidities, and organ system dysfunctions related to the disease burden of postoperative sepsis episodes are unclear.MethodsWe analyzed epidemiological characteristics of postoperative sepsis based on the ICD-9-CM codes for the years 2002 to 2013 using the Longitudinal Health Insurance Databases of Taiwan’s National Health Insurance Research Database.ResultsWe identified 5,221 patients with postoperative sepsis and 338,279 patients without postoperative sepsis. The incidence of postoperative sepsis increased annually with a crude mean of 0.06% for patients aged 45–64 and 0.34% over 65 years. Patients with postoperative sepsis indicated a high risk associated with the characteristics, male sex (OR:1.375), aged 45–64 or ≥ 65 years (OR:2.639 and 5.862), low income (OR:1.390), aged township (OR:1.269), agricultural town (OR:1.266), and remote township (OR:1.205). Splenic surgery (OR:7.723), Chronic renal disease (OR:1.733), cardiovascular dysfunction (OR:2.441), and organ system dysfunctions had the highest risk of postoperative sepsis.ConclusionRisk of postoperative sepsis was highest among men, older, and low income. Patients with splenic surgery, chronic renal comorbidity, and cardiovascular system dysfunction exhibited the highest risk for postoperative sepsis. The evaluation of high-risk factors assists in reducing the disease burden.
Highlights
Sepsis is the most severe manifestation of acute infection, causing a complex syndrome that may result in multiple organ failures and resulting in death in 30–50% cases [1, 2]
The results indicated a high risk of postoperative sepsis among the following categories of patients: men, aged 45–64 and ≥ 65 years, low income, aged township, agricultural town, and remote township
The specific comorbidities and organ system dysfunctions associated with the highest risk of postoperative sepsis were diabetes, chronic heart failure, Figure 2: (A) Incidence of postoperative sepsis by age group (B) Incidence of postoperative sepsis by surgery type
Summary
Sepsis is the most severe manifestation of acute infection, causing a complex syndrome that may result in multiple organ failures and resulting in death in 30–50% cases [1, 2]. A major cause of morbidity and mortality worldwide, is one of the 10 leading causes of death in Taiwan and the United States [3]. In the United States, approximately 164,000 cases of sepsis occurred each year during the 1970s [4]. According to studies performed by the National Center for Health Statistics, the incidence of sepsis has risen from 221 cases per 100,000 persons in 2000 to 377 per 100,000 persons in 2008, which is an increase of 7%–8% per year [5, 6]. In Taiwan, a nationwide population-based study demonstrated that the incidence of severe sepsis rose from 135 cases per 100,000 persons in 1997 to 217 per 100,000 persons in 2006, which is an approximately 3.9% increase per year [7]. Sociodemographic characteristics, incidence trends, surgical procedures, comorbidities, and organ system dysfunctions related to the disease burden of postoperative sepsis episodes are unclear
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