Sepsis-Update: Definition und Epidemiologie

Zusammenfassung

Sepsis ist eine häufige Erkrankung auf den Intensivstationen weltweit, die mit einer relevanten Morbidität und Mortalität einhergeht. Bis heute gibt es keine spezifische Therapie der Sepsis – allein die frühe Diagnosestellung und schnellstmögliche therapeutische Intervention können das Outcome der Patienten verbessern. Daher ist eine Definition des Krankheitsbildes der Sepsis mit hoher diagnostischer Sensitivität und Spezifität unabdingbar.

Abstract

Sepsis is a common disease in intensive care units worldwide, which is associated with relevant morbidity and mortality. Although massive research efforts have been made for decades, there is no specific therapy for sepsis to date. Decisive in the treatment of sepsis is the early diagnosis, because the outcome of the treated patients can be significantly improved by early elimination of the infection focus, the fastest possible administration of a broad, calculated antibiosis as well as the stabilization of the hemodynamic situation. A definition of the clinical picture of sepsis with high diagnostic sensitivity and specificity is therefore indispensable. This article describes the previously and the currently available definition of sepsis and gives an overview of the epidemiology of this disease.

Kernaussagen

• Eine Definition des Krankheitsbildes der Sepsis mit hoher diagnostischer Sensitivität und Spezifität ist entscheidend für eine frühzeitige Behandlung der Patienten mit Sepsis.

• Als Sepsis wird eine lebensbedrohliche Organdysfunktion definiert, die durch eine dysregulierte Immunantwort des Patienten auf eine Infektion verursacht wird.

• Bei Patienten im septischen Schock sind die zugrunde liegenden zirkulatorischen, zellulären und metabolischen Veränderungen mit einem größeren Letalitätsrisiko assoziiert als bei Patienten mit einer alleinigen Sepsis.

• Die Intensivstations- bzw. Gesamtkrankenhausletalität lag in der INSEP-Studie mit den alten Sepsisdefinitionen im septischen Schock bei 37,3 bzw. 43,3%. Mit der neuen Sepsis-3-Definition betrug sie 44,3 bzw. 50,9%.

• Schwere Sepsis und septischer Schock sind die dritthäufigste Todesursache im Krankenhaus.

Schlüsselwörter

Sepsis - Epidemiologie - Organdysfunktion - Immunantwort - SOFA-Score

Key words

sepsis - epidemiology - organ dysfunction - immune response - SOFA-score

^* Hendrik Bracht und Sebastian Hafner haben gleichermaßen zur Arbeit beigetragen.

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