Sepsis syndrome in Croatian intensive care units: piloting a national comparative clinical database.

The sepsis syndrome, severe sepsis, and septic shock represent a major therapeutic and economic problem. In the intensive care units (ICUs) in the European Union (EU) member states, severe sepsis and septic shock result in 135 000 deaths per year with associated costs of €7.6 billion (1). The meeting of the European Society on Intensive Care Medicine in Barcelona in 1992 resulted in the Declaration on the need for standardization of diagnostics, treatment strategy, and outcome analysis in these patients (2). A large Sepsis Occurrence in Acutely ill Patients (SOAP) study provided data on the incidence of sepsis in the ICUs in EU member states, patients’ characteristics, management, and outcomes (3). Data on the incidence of sepsis in central European countries are less available. The Croatian National Institute of Public Health collects the national data on the incidence of sepsis, but does not collect any additional data, such as those on treatment or outcomes. Also, the incidence data are considered to be incomplete (4). The croicu.net project was started in November 2004 to fill the gap in documenting the case mix, treatments, and outcomes in Croatian ICUs (5). The still ongoing pilot phase rests on voluntary participation of 24 ICUs. The final aim is to establish a national clinical database that would inform policy and foster professional development through enabling comparative audits of ICUs nationwide. We analyzed the data collected through croicu.net from November 1, 2004, to October 31, 2005, to assess the incidence of sepsis in the Croatian ICUs participating in the project, isolates from blood cultures, and outcomes, and to compare Croatian data with those from other European countries.