Mortality of Sepsis in Swedish Intensive Care Units 2008-2016

Study Overview
=================
Brief Summary
-----------------
A study of short and long term mortality in patients treated with or without a diagnosis of sepsis in Swedish intensive care units (ICU) 2008 - 2016. The cohort is characterized with regard to chronic comorbidity, severity of acute illness and demographic factors, and outcome is adjusted for these factors. Changes in mortality during the period are studied.

Detailed Description
-----------------
All adult patients admitted to a general ICU included in the Swedish Intensive Care Registry (a majority of all ICUs in Sweden) between 2008-01-01 and 2016-10-18 are followed for one year and any deaths are registered. Data on illness severity scores, age, sex, admitting hospital and duration of ICU stay are recovered. Data are linked with the inpatient registry of the Swedish Board of Health and Welfare (Socialstyrelsen), and any discharge diagnoses from the last 5 years preceding ICU admission are recovered. These are used to assess chronic comorbidity. Mortality, adjusted for severity of illness, comorbidity and patient factors, is studied and any changes over time during the inclusion period are assessed. The data in the Swedish ICU Registry are entered by the treating ICU physicians and include severity of illness (Simplified Acute Physiology Score (SAPS)3), selected chronic comorbidity, sex and date of birth, ICU stay and selected interventions and complications. Relevant International Classification of Diseases (ICD)-10 diagnoses are required and assessment of the occurrence of severe sepsis or septic shock, during the inclusion period defined according to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) (sepsis 2) criteria, is mandatory when entering data.

Official Title
-----------------
Mortality of Sepsis in Swedish Intensive Care Units 2008-2016

Conditions
-----------------
Sepsis

Intervention / Treatment
-----------------
* Other: ICU care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Admission to a Swedish general ICU (excluding specialized cardiothoracic, neurosurgical, pediatric and burns units) between 2008-01-01 and 2016-10-18 Episode registered in Swedish Intensive Care Registry Exclusion Criteria: Age < 18 years Readmission (only first episode during the period included)

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sepsis group<br>All adult (>= 18 years) patients with a diagnosis of sepsis included in the Swedish ICU Registry between 2008-01-01 and 2016-10-18 | Other: ICU care<br>* exposure to ICU treatment with or without diagnosed sepsis<br>|
| Non-sepsis group<br>All adult (>=18 years) patients without a diagnosis of sepsis included in the Swedish ICU Registry between 2008-01-01 and 2016-10-18 | Other: ICU care<br>* exposure to ICU treatment with or without diagnosed sepsis<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 day mortality | mortality within 30 days after admission to ICU | From the day of ICU admission until death of any cause , whichever came first, assessed up to 30 days. | 
| 90 day mortality | mortality within 90 days after admission to ICU | From the day of ICU admission until death of any cause, whichever came first, assessed up to day 90. | 
| 365 day mortality | mortality within 365 days after admission to ICU | From the day of ICU admission until death of any cause , whichever came first, assessed up to day 365. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hospital mortality | mortality before discharge from hospital after admission to ICU | From the day of ICU admission until death of any cause or day of hospital discharge, whichever came first, assessed up to day 365. | 
| ICU length of stay |  | From the day of ICU admission until death of any cause or day of ICU discharge, whichever came first, assessed up to day 365. | 
| hospital length of stay |  | From the day of ICU admission until death of any cause or day of hospital discharge , whichever came first, assessed up to day 365. |