• Yueh-Sheng Chen, Tin-Yun Liao, Tzu-Chun Hsu, Wan-Ting Hsu, Meng-Tse G Lee, Chien-Chang Lee, and National Taiwan University Hospital Biomedical Data Science Research Group.
• Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
• Crit Care Resusc. 2020 Jun 1; 22 (2): 126132126-132.

BackgroundTo determine the temporal trends of incidence and outcome based on different sources of sepsis using a nationwide administrative database.MethodsFrom 2002 to 2012, the entire Taiwan's health insurance claims data of emergency-treated and hospital-treated sepsis were analysed for incidence and mortality trends. The information about patients with sepsis and sources of sepsis was identified using a set of validated International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) codes. The 30-day all-cause mortality was verified by linked death certificate database.ResultsA total of 1 259 578 episodes of sepsis were identified during the 11-year study period. Lower respiratory tract infection is the most common source of sepsis in patients, with the highest mortality rate. The incidence of genitourinary tract infection has the fastest growing rate. The sepsis mortality was declining at different rates for each source of sepsis. Co-infections in patients with sepsis are associated with higher mortality rate.ConclusionThe temporal trends of sepsis incidence and mortality varied among different sources of sepsis, with lower respiratory tract being the highest burden among patients with sepsis. Furthermore, sources of sepsis and the presence of co-infection are independent predictors of mortality. Our results support source-specific preventive and treatment strategies for future sepsis management.

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