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Costs of severe sepsis according to the guidelines of the 'Surviving Sepsis Campaign'

Introduction

Despite advanced organ support, patients suffering from severe sepsis still have a high mortality rate [1]. Recently, it has been advocated to follow the 'Surviving Sepsis Campaign' (SSC) [2] to treat patients suffering from severe sepsis. Even though it is unpredictable which patient will survive and for what reason, an important amount of the ICU budget has to be invested on drugs and supplies (DS). Therefore, the present study aimed to determine the amount of money that our ICU (which is administrated by public funds) has to invest on DS to treat a patient suffering from severe sepsis.

Methods

Data on costs for DS were recorded daily for every patient admitted to the ICU from June to October 2004. Patients with severe sepsis were separated from the main database. Costs for each item of the SSC (including activated protein C) were taken as independent variables, and the survey as a dependent variable. We used the cost of each DS exactly as it was sold to our institution. Costs are presented in Euros according to the currency rate at 30 October 2004.

Results

During the 5-month period, 211 patients were admitted to the ICU. The treatment for severe sepsis according to the SSC was affordable for all patients admitted to the ICU. The cost for DS during this period was €327,026.36. Of all ICU patients, 37 (17.53%) suffered from severe sepsis and the DS cost for this group was €146,513.10. Postoperative sepsis was observed in 18 patients (48.6%) while 19 (51.3%) were non-postoperative sepsis; the cost for DS in these two groups was €58,294.61 and €88,218.49, respectively. The total costs for DS to produce a 43% survival on severe sepsis was €55,121.38; that is, postoperative sepsis €30,253.91 and non-postoperative sepsis €24,867.48. The cost for patients who died was €91,391.72. Patients who died with non-postoperative sepsis had the highest DS costs (i.e. €63,351.01). The investment to save 16 patients was €63,357.02.

Conclusions

In our ICU, and following the SSC guidelines, we have to invest in every patient suffering from severe sepsis at least €9157.07 to produce a 43% survival. That means, in the future, any increase in survival with the same investment on DS may reflect our best approach to treat severe sepsis.

References

  1. 1.

    Moerer O, Burchardi H: The costs of sepsis. ICU management 2004, 4: 25-29.

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  2. 2.

    Dellinger PR, Carlet JM, Masur H, Gerlach H, Calandra T, et al.: Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004, 32: 858-873. 10.1097/01.CCM.0000117317.18092.E4

    PubMed  Article  Google Scholar 

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de Anda, G.V., Rangel, T.M., Villafaña, J.A. et al. Costs of severe sepsis according to the guidelines of the 'Surviving Sepsis Campaign'. Crit Care 9, P198 (2005). https://doi.org/10.1186/cc3261

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Keywords

  • Public Health
  • Mortality Rate
  • High Mortality
  • Emergency Medicine
  • Severe Sepsis