Clinical scenario of sepsis: reclassification of severe infection syndrome with organ failures

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K19376
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: University of Tsukuba
• Principal Investigator: Abe Toshikazu 筑波大学, 医学医療系, 客員教授 (70633973)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 敗血症 / テーラーメード医療 / 症候群 / ガイドライン

Outline of Final Research Achievements

Sepsis is a syndrome of infection and organ failures. Although speed of treatment initiation is vital, implementation is more difficult because the clinical phenotype is much more complex than in other emergency diseases. Therefore, we aimed to risk stratify patients with sepsis for ease of clinical application, rather than bundling all sepsis together. First, we examined the reclassification of sepsis by site of infection, difference of the diagnosis of sepsis, and the impact of different definitions. We also evaluated subgroups with different causes, such as fungi. Next, risk assessment by patient background factors was also investigated. The association between clinical outcomes and positive blood cultures and severe respiratory failure was also analyzed. The impact of sepsis guidelines and treatment bundles was also examined. These results are consistent with recent global evidence, and our studies supports the direction of sepsis practice in the world.

Free Research Field

救急・集中治療

Academic Significance and Societal Importance of the Research Achievements

敗血症は重症救急患者の主要原因であり、予後も悪い。しかし、未だ予後を劇的に改善させる医療手段は見つかっていない。研究者は複雑な敗血症を一つの塊として対応することが問題の一つと考えた。つまり、一重に敗血症患者といっても、リスクや表現系のサブタイプがあり、それぞれに治療反応性や予後に大きな違いがある。
研究者が調査・解析し、報告した項目は全て現在、敗血症診療で当たり前に行われていることである。当たり前の診察や診断、治療にも良し悪し、改善点がある。今回の研究を用いて、もう一度、それらを見直しことができた。今回の研究結果は敗血症診療の質の改善につながると思われる。