@article{14b58c243773427bbdb950d8c6d33224,
title = "Adult sepsis – A nationwide study of trends and outcomes in a population of 23 million people",
abstract = "Objectives To determine the trend of incidence and outcome of sepsis based on a nationwide administrative database. Methods We analyzed the incidence and mortality of both emergency department treated and hospital treated sepsis from 2002 through 2012 using the entire health insurance claims data of Taiwan. The national health insurance covers 99% of residents in Taiwan. Sepsis patients were identified using a set of validated ICD-9CM codes conforming to the sepsis-3 definition. The 30-day all-cause mortality was verified by linked death certificate database. Results During the 11-year study period, a total of 1,259,578 episodes of sepsis was identified. The mean incidence rate was 639 per 100,000 person-years, increasing from 637.8/100,000 persons in 2002 to 772.1/100,000 persons in 2012 (annual increase: 1.9%). The mortality rate, however, has decreased from 27.8% in 2002 to 22.8% in 2012 (annual decrease: 0.45%). The trend of incidence and mortality did not change after standardization by age and gender using 2002 as the reference standard. Conclusion We showed that the incidence of sepsis has increased while the mortality has decreased in Taiwan. Despite the decreasing trend in sepsis mortality, the total number of sepsis mortality remains increasing due to the rapid increase in sepsis incidence.",
keywords = "Incidence, Mortality, Nationwide database, Sepsis",
author = "Lee, {Chien Chang} and Yo, {Chia Hung} and Lee, {Meng tse Gabriel} and Tsai, {Kuang Chau} and Lee, {Shih Hao} and Chen, {Yueh Sheng} and Lee, {Wan Chien} and Hsu, {Tzu Chun} and Lee, {Sie Hue} and Chang, {Shy Shin}",
note = "Funding Information: We analyzed the entire National Health Insurance claims database of Taiwan between 2002 January 1 and December 31, 2012. The database was developed as part of the National Health Informatics Project (NHIP) sponsored by the Ministry of Health and Welfare of Taiwan. The database contains information for nearly the entire 23 million residents of Taiwan, as the National Health Insurance of Taiwan is a government operated, mandatory health insurance system with 99.7% coverage rate. The insurance plan guarantees unfettered access to outpatient or inpatient medical care, and partial reimbursement of prescribed drug. 16–18 More than 95% of Taiwanese population are Han Chinese, and the second largest ethnic group is of Austronesian Ancestry (∼2%). 19 Since this is an anonymized electronic database study, patient consent is not required. Our study was approved by the institutional review board of National Taiwan University Hospital. Funding Information: This study is supported by the Taiwan National Science Foundation [grant number NSC 102-2314-B-002-131-MY3 ]; Taiwan National Ministry of Science and Technology [grants numbers MOST 104-2314-B-002-039-MY3 , and MOST 106-2811-B-002-048 ]; Far Eastern Memorial Hospital [grant number FEMH-2016-C-028 ]. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2017 The British Infection Association",
year = "2017",
month = nov,
doi = "10.1016/j.jinf.2017.08.012",
language = "English",
volume = "75",
pages = "409--419",
journal = "Journal of Infection",
issn = "0163-4453",
publisher = "W.B. Saunders Ltd",
number = "5",
}
