• Seitaro Fujishima, Satoshi Gando, Daizoh Saitoh, Toshihiko Mayumi, Shigeki Kushimoto, Shin-Ichiro Shiraishi, Hiroshi Ogura, Kiyotsugu Takuma, Joji Kotani, Hiroto Ikeda, Norio Yamashita, Koichiro Suzuki, Ryosuke Tsuruta, Naoshi Takeyama, Tsunetoshi Araki, Yasushi Suzuki, Yasuo Miki, Yoshihiro Yamaguchi, Naoki Aikawa, and Japanese Association for Acute Medicine Sepsis Registry (JAAM SR) Study Group.
• Department of Emergency & Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Electronic address: fujishim@z6.keio.jp.
• J. Infect. Chemother. 2014 Feb 1;20(2):115-20.

AbstractTo elucidate the standard Surviving Sepsis Campaign (SSC) guidelines-based quality of care and mortality related to severe sepsis in Japan, we conducted a multicenter, prospective, observational study using a new web-based database between June 1, 2010, and December 31, 2011. A total of 1104 patients with severe sepsis were enrolled from 39 Japanese emergency and critical care centers. All-cause hospital mortality was 29.3% in patients with severe sepsis and 40.7% in patients with septic shock. Pulmonary, renal, hepatic, and hematological dysfunctions were associated with significantly higher mortality, and hematological dysfunction, especially coagulopathy, was associated with the highest odds ratio for mortality. Compliance with severe sepsis bundles in our study was generally low compared with that in a previous international sepsis registry study, and glycemic control was associated with lowest odds ratio for mortality. Despite higher complication rates of multiple organ dysfunction syndrome and low compliance with severe sepsis bundles on the whole, mortality in our study was similar to that in the international sepsis registry study. From these results, we concluded that our prospective multicenter study was successful in evaluating SSC guidelines-based standard quality of care and mortality related to severe sepsis in Japan. Although mortality in Japan was equivalent to that reported worldwide in the above-mentioned international sepsis registry study, compliance with severe sepsis bundles was low. Thus, there is scope for improvement in the initial treatment of severe sepsis and septic shock in Japanese emergency and critical care centers.Copyright © 2013 Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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