Außerordentliche ökonomische Belastung - Epidemiologie und Kosten der Sepsis

Zusammenfassung

Noch immer ist die schwere Sepsis eine der Haupttodesursachen auf der Intensivstation und damit eine große Bedrohung für die Patienten. So entwickeln 2-3 % der Patienten einer Normalstation und 10-15 % der Intensivpatienten eine schwere Sepsis oder einen septischen Schock. Allein in Deutschland erkranken jedes Jahr zwischen 44000 und 95000 Menschen an schwerer Sepsis, und 30-50 % dieser Patienten versterben während ihres Krankenhausaufenthalts. Aber auch wenn diese die Sepsis anfänglich überleben, bleibt ihr Mortalitätsrisiko noch über Jahre hinweg erhöht - und zwar abhängig von Aufnahmeursache, Krankheitsschwere, Alter, Nebenerkrankungen und der Lokalisation der zugrunde liegenden Infektion. Aus der hohen Inzidenz und dem großen Anteil kostenintensiver intensivmedizinischer Behandlungsmaßnahmen resultieren hohe Krankenhauskosten. Ergänzt man auch die so genannten indirekten Kosten, ergeben sich für Deutschland jährliche Aufwendungen zwischen 3647 und 7847 Milliarden Euro. Damit ist die Sepsis eine außerordentliche ökonomische Belastung, sodass die Entwicklung neuer therapeutischer Standards sowie eingehende Untersuchungen zu den Kosten dringend erforderlich sind.

Summary

Despite great efforts in clinical research severe sepsis remains a serious health care problem being among the leading causes of death in intensive care therapy. 2-3 % of ward patients and 10-15 % ICU patients develop severe sepsis or septic shock. Every year between 44000 and 95000 patients in Germany suffer from severe sepsis and 30-50 % of them are dying from the disease during their hospital stay. But even after initial survival mortality is increased in these patients for several years. The mortality is influenced by reason of admission, severity of illness, age, comorbidities and primary site of infection. Due to the incidence and the expensive effort of intensive care therapy of such patients, sepsis consumes considerable recourses and results in significant hospital costs. Adding indirect costs due to temporary or permanent morbidity severe sepsis imposes annual costs between 3647 und 7847 billion Euros in Germany. Thus, sepsis is a tremendous cost driver not only from the ICU but also from hospital or society's perspective. There is an urgent need for therapeutic standards and innovative therapies in the treatment of sepsis to improve outcome as well as for further cost studies to improve our knowledge.

Key Words

sepsis - cost of treatment - health care costs - hospital costs

Literatur

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1 acute physiology and chronic health evaluation

2 administration of drotrecogin alfa (activated) in early severe sepsis

Anschrift für die Verfasser