In this issue of The Journal, Sands et al1 present important results in an epidemiologic study of sepsis in 8 academic medical centers. The most interesting conclusion is that sepsis occurred in as many as 2 cases per 100 admissions in academic tertiary care centers. This rate is much higher than that found in previous investigations2 and probably results from more complicated cases, a higher incidence of nosocomial infection, and inclusion of non-intensive care unit (ICU) patients. For example, Brun-Buisson et al3 looked at the incidence of sepsis in ICUs in France and found an attack rate of 9% overall and 10.3% in very large institutions. In the study by Sands et al, ICU patients accounted for only 59% of the cases; of the 41% remaining non-ICU patients, 11% had positive blood cultures and 30% had negative blood cultures.
See also p 234.
This analysis also supports