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Sepsis incidence and mortality are underestimated in Australian intensive care unit administrative data

Jake C Valentine, Gabrielle Haeusler, Leon Worth and Karin Thursky
Med J Aust 2019; 210 (4): . || doi: 10.5694/mja2.50017
Published online: 4 March 2019

TO THE EDITOR: We commend Heldens and colleagues1 for publishing their data on the incidence and in‐hospital mortality of sepsis and septic shock among patients admitted to Australian intensive care units (ICUs). The incidence of sepsis and septic shock in ICUs is estimated to be 101.8 and 19.3 per 100 000 patient‐years, respectively, at an attributable cost of $32 421.2 We concur that sepsis cases captured using the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation database criteria, compared with prospective clinical diagnoses,3 has poor sensitivity for sepsis case ascertainment.


  • 1 Peter MacCallum Cancer Centre, Melbourne, VIC
  • 2 Doherty Institute, Melbourne, VIC



Acknowledgements: 

We thank Professor Karin Thursky, custodian of the data presented in the Box.

Competing interests:

No relevant disclosures.

  • 1. Heldens M, Schout M, Hammond NE, et al. Sepsis incidence and mortality are underestimated in Australian intensive care unit administrative data. Med J Aust 2018; 209: 255–260. https://www.mja.com.au/journal/2018/209/6/sepsis-incidence-and-mortality-are-underestimated-australian-intensive-care-unit
  • 2. Shankar‐Hari M, Harrison DA, Rubenfeld GD, Rowan K. Epidemiology of sepsis and septic shock in critical care units: comparison between sepsis‐2 and sepsis‐3 populations using a national critical care database. Br J Anaesth 2017; 119: 626–636.
  • 3. Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101: 1644–1655.
  • 4. Thursky K, Lingaratnam S, Jayarajan J, et al. Implementation of a whole of hospital sepsis clinical pathway in a cancer hospital: impact on sepsis management, outcomes and costs. BMJ Open Qual 2018; 7: e000355.
  • 5. van Mourik MSM, Perencevich EN, Gastmeier P, Bonten MJM. Designing surveillance of healthcare‐associated infections in the era of automation and reporting mandates. Clin Infect Dis 2018; 66: 970–976.

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