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  1. Has the mortality of septic shock changed with time ?

    Article - En anglais

    Objectives 

    To determine whether a systematic review of the literature could identify changes in the mortality of septic shock over time.

    Data Sources 

    A review of all relevant papers from 1958 to August 1997, identified through a MEDLINE search and from the bibliographies of articles identified.

    Data Synthesis 

    The search identified 131 studies (99 prospective and 32 retrospective) involving a total of 10,694 patients.

    The patients'mean age was 57 yrs with no change over time.

    The overall mortality rate in the 131 studies was 49.7%. There was an overall significant trend of decreased mortality over the period studied (r2=49, p<. 05).

    The mortality rate in those patients with bacteremia as an entry criterion was greater than that rate in patients whose entry criterion was sepsis without definite bacteremia (52.1% vs. 49.1% ; x2=6.1 and p<. 05).

    The site of infection altered noticeably over the years.

    Chest-related infections increased over time, with Gram-negative infections becoming proportionately less common.

    If all other organisms and mixed infections are included with the Gram-positives, the result is more dramatic, with these organisms being causative in just 10% of infections between 1958 and 1979 but in 31% of infections between 1980 and 1997.

    Conclusions 

    The present review showed a slight reduction in mortality from septic shock over the years, although this result should be approached with caution. (...)

    Mots-clés Pascal : Choc, Septique syndrome, Infection, Mortalité, Epidémiologie, Evolution, Taux, Pronostic, Homme, Revue bibliographique, Appareil circulatoire pathologie, Soin intensif

    Mots-clés Pascal anglais : Shock, Sepsis syndrome, Infection, Mortality, Epidemiology, Evolution, Rate, Prognosis, Human, Bibliographic review, Cardiovascular disease, Intensive care

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0068796

    Code Inist : 002B27B02. Création : 31/05/1999.