Has the prognosis of septic patients improved over time

摘要: Over the last decades multiple clinical trials searching for an effective pharmacological treatment sepsis have failed to identify ‘a magic bullet’ that significantly improves outcome in patients suffering from sepsis. Moreover, several interventions appeared exert beneficial effects were not confirmed be randomised controlled trials. 2-4 It seems suffers more negative than any other disease. Yet, despite absence of a single treatment, March this year Kaukonen and co-workers published retrospective, observational study which they reported overall decrease mortality Australia New Zealand. 5 one decade, 171 participating ICUs, 100,000 included. In detail, absolute severe decreased 35.0% 2000 18.4% 2012. This represents 16.7%, with gradual decline 1.3% annually. is compelling epidemiological on first sight may conclude prognosis has improved considerably. However, caution needed interpretation studies. Several possible explanations observed need addressed. Similar discussions related population-wide screening cancer, increased awareness also lead earlier diagnosis patients. The subsequent less advanced disease suggest better survival time (and thus lower mortality), while truly case. Indeed, Kaukonen’s study, over fewer suffered concomitant respiratory failure (60 vs 37%) or renal (30 25%), important covariates are mostly present at ICU admission known influence outcome. Also, according quartiles APACHE III scores as measure their severity illness, sick admitted incidence urosepsis (with