{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:28:53Z","timestamp":1793795333545,"version":"4.6.1"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","funder":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine","award":["2023-11"],"award-info":[{"award-number":["2023-11"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To examine contemporary nationwide trends in sepsis incidence and mortality in South Korea and the associated clinical and socioeconomic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>Retrospective, population-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING:<\/jats:title>\n                    <jats:p>Korea\u2019s healthcare system from 2011 to 2022, utilizing the National Health Insurance Service database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS:<\/jats:title>\n                    <jats:p>\n                      Adult patients 18 years old or older hospitalized for sepsis and identified using the\n                      <jats:italic toggle=\"yes\">International Classification of Diseases<\/jats:italic>\n                      , 10th Revision codes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTIONS:<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS AND MAIN RESULTS:<\/jats:title>\n                    <jats:p>\n                      Incidence and mortality were analyzed annually over the study period. Poisson and linear regression models were used to analyze temporal trends in sepsis incidence and mortality. Multivariable logistic regression was performed to evaluate risk factors for in-hospital mortality. In all, 1,149,379 sepsis cases were identified. The crude incidence of sepsis increased from 141.8 to 337.3 per 100,000 person-years from 2011 to 2022, whereas the age-standardized incidence increased by 53.1%. In-hospital mortality decreased from 27.0% to 17.0%. Poisson regression analysis showed significant increases in crude and age-standardized incidence (incidence rate ratio [IRR], 1.09; 95% CI, 1.08\u20131.09;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001 and IRR, 1.04; 95% CI, 1.04\u20131.04;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001, respectively). In-hospital mortality consistently declined from 27.0% in 2011 to 17.0% in 2022 (\u03b2 = \u20131.1%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001;\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.91). However, the total number of deaths increased from 15,605 in 2011 to 25,326 in 2022 (\u03b2 = 779;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001;\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.98). Multivariable analysis identified that older age, male sex, higher comorbidity burden, and greater disease severity were independent risk factors for mortality. Socioeconomic disparities were evident: medical aid beneficiaries and rural residents had higher mortality, whereas treatment at tertiary hospitals was associated with improved outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this nationwide claims-based study, recorded sepsis incidence increased and in-hospital mortality declined over time, although these trends warrant cautious interpretation given potential shifts in case identification practices. Socioeconomic disparities in mortality persisted throughout the study period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007306","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:00:10Z","timestamp":1786975210000},"page":"2824-2834","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Incidence, Outcomes, and Risk Factors for Mortality in Patients With Sepsis in South Korea: A Nationwide Cohort Study"],"prefix":"10.1097","volume":"54","author":[{"given":"Dongwook","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongseop","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaewoong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ah","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Young","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Jin","family":"Jeong","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Yong","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Sup","family":"Yeom","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Kyoung","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Su","family":"Ku","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"R1-20261104","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for sepsis and septic shock (Sepsis-3).","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"R2-20261104","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990-2017: Analysis for the Global Burden of Disease 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mortality, cost and risk factors for death in sepsis.","volume":"6","author":"Kim","year":"2019","journal-title":"Clin Exp Emerg Med"},{"key":"R7-20261104","doi-asserted-by":"crossref","first-page":"e993","DOI":"10.1097\/CCM.0000000000004041","article-title":"Incidence and outcomes of sepsis in Korea: A nationwide cohort study from 2007 to 2016.","volume":"47","author":"Oh","year":"2019","journal-title":"Crit Care Med"},{"key":"R8-20261104","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12939-024-02114-6","article-title":"Rapid systematic review on risks and outcomes of sepsis: The influence of risk factors associated with health inequalities.","volume":"23","author":"Bladon","year":"2024","journal-title":"Int J Equity Health"},{"key":"R9-20261104","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1111\/aas.13114","article-title":"Socioeconomic status and risk of intensive care unit admission with sepsis.","volume":"62","author":"Storm","year":"2018","journal-title":"Acta Anaesthesiol Scand"},{"key":"R10-20261104","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1093\/jalm\/jfaa151","article-title":"Impact of socioeconomic status and race on sepsis epidemiology and outcomes.","volume":"6","author":"Minejima","year":"2021","journal-title":"J Appl Lab Med"},{"key":"R11-20261104","doi-asserted-by":"crossref","first-page":"e2014008","DOI":"10.4178\/epih\/e2014008","article-title":"A guide for the utilization of Health Insurance Review and Assessment Service National Patient Samples.","volume":"36","author":"Kim","year":"2014","journal-title":"Epidemiol Health"},{"key":"R12-20261104","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3961\/jpmph.23.250","article-title":"Adjusting for confounders in outcome studies using the Korea National Health Insurance Claim Database: A review of methods and applications.","volume":"57","author":"Han","year":"2024","journal-title":"J Prev Med Public Health"},{"key":"R13-20261104","doi-asserted-by":"crossref","first-page":"e2331168","DOI":"10.1001\/jamanetworkopen.2023.31168","article-title":"Estimating sepsis incidence using administrative data and clinical medical record review.","volume":"6","author":"Mellhammar","year":"2023","journal-title":"JAMA Netw Open"},{"key":"R14-20261104","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"key":"R15-20261104","doi-asserted-by":"crossref","first-page":"e035501","DOI":"10.1136\/bmjopen-2019-035501","article-title":"Comparison between urban and rural mortality in patients with acute myocardial infarction: A nationwide longitudinal cohort study in South Korea.","volume":"10","author":"Kim","year":"2020","journal-title":"BMJ Open"},{"key":"R19-20261104","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1513\/AnnalsATS.201411-498BC","article-title":"Trends in sepsis and infection sources in the United States. A population-based study.","volume":"12","author":"Walkey","year":"2015","journal-title":"Ann Am Thorac Soc"},{"key":"R20-20261104","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1007\/s00134-018-5377-4","article-title":"Challenges in assessing the burden of sepsis and understanding the inequalities of sepsis outcomes between National Health Systems: Secular trends in sepsis and infection incidence and mortality in Germany.","volume":"44","author":"Fleischmann-Struzek","year":"2018","journal-title":"Intensive Care Med"},{"key":"R21-20261104","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1186\/s13054-021-03762-8","article-title":"Trends in the incidence and outcome of sepsis using data from a Japanese nationwide medical claims database-the Japan Sepsis Alliance (JaSA) study group.","volume":"25","author":"Imaeda","year":"2021","journal-title":"Crit 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compliance with sepsis bundles and mortality: A systematic review and meta-analysis of observational studies.","volume":"10","author":"Damiani","year":"2015","journal-title":"PLoS One"},{"key":"R29-20261104","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1097\/CCM.0000000000000297","article-title":"Guideline bundles adherence and mortality in severe sepsis and septic shock.","volume":"42","author":"van Zanten","year":"2014","journal-title":"Crit Care Med"},{"key":"R30-20261104","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1001\/jama.299.19.2294","article-title":"Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain.","volume":"299","author":"Ferrer","year":"2008","journal-title":"JAMA"},{"key":"R31-20261104","first-page":"159","article-title":"Hospital incidence and mortality rates of sepsis: An analysis of hospital episode (DRG) statistics in Germany from 2007 to 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Med Klin Intensivmed Notfmed].","volume":"117","author":"Fleischmann-Struzek","year":"2022","journal-title":"Med Klin Intensivmed Notfmed"},{"key":"R49-20261104","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1186\/s12879-025-11000-7","article-title":"Impacts of the COVID-19 pandemic on sepsis incidence, etiology and hospitalization costs in France: A retrospective observational study.","volume":"25","author":"Al Rahmoun","year":"2025","journal-title":"BMC Infect Dis"}],"container-title":["Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:00:21Z","timestamp":1793793621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":46,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/ccm.0000000000007306","relation":{},"ISSN":["0090-3493","1530-0293"],"issn-type":[{"value":"0090-3493","type":"print"},{"value":"1530-0293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]}}}