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Sepsis-related mortality higher in Europe than US
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New data from the Surviving Sepsis Campaign indicate there was a significant difference in unadjusted mortality among patients with severe sepsis in Europe compared with patients in the United States.
The unadjusted results show that the odds of hospital mortality were between 51% and 65% higher in Europe compared with the United States. After adjustment, the odds of hospital mortality were between 5% and 19% higher in Europe than in the United States, but this was not significant.
“A major difference between the approaches to care in the United States and those in Europe is that the US model admits more patients directly to ICUs from emergency departments,” the researchers reported in The Lancet Infectious Diseases. “These different approaches to care for severe sepsis and septic shock allow for regional comparisons that might inform alternative treatment approaches for this susceptible population.”
The cohort included 25,375 patients: 18,766 patients were from the United States and 6,609 were from Europe. In the United States, 65.1% of the patients were admitted to the ICU from the ED, but in Europe, 51.5% of patients were admitted from the general wards. The median hospital stay before ICU admission was also longer in Europe, 1 day vs. 0.1 days. The median length of stay in the ICU and the hospital were longer in Europe.
“Our study raises important questions,” the researchers wrote. “Is the higher mortality rate in Europe due to the lower number of ICU beds available in Europe …? Or is the use of ICU resources … excessive in the USA? Further studies are needed to elucidate more precisely the effect of these models on outcomes of sepsis.”
Disclosure: The researchers report financial relationships with Biomerieux, Edwards Lifesciences, Eli Lilly, LiDCO, Orion Pharmaceuticals and Philips Medical Systems.
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