{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:29:11Z","timestamp":1783016951633,"version":"3.54.6"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T00:00:00Z","timestamp":1606608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004103","name":"Landsp\u00edtali H\u00e1sk\u00f3lasj\u00fakrah\u00fas","doi-asserted-by":"publisher","award":["A\u20102020\u2010061"],"award-info":[{"award-number":["A\u20102020\u2010061"]}],"id":[{"id":"10.13039\/501100004103","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sepsis requiring admission to intensive care (ICU) is a rare complication of elective surgery, but is associated with high morbidity and mortality. The aim of this study was to describe the incidence and outcome of sepsis following elective surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, observational study where all admissions to Icelandic ICUs during calendar years 2006, 2008, 2010, 2012, 2014 and 2016 were screened, identifing patients with sepsis following elective surgery (ACCP\/SCCM criteria). The number of elective operations performed at the largest center (Landspitali) during the study years were collected. Descriptive statistics were used to assess the incidence and outcome of patients with sepsis after elective surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study years, 88 patients were admitted to Icelandic ICUs with sepsis following elective surgery. Of those, 80 were operated at Landspitali, where the incidence of sepsis was 0.19% per elective procedure, highest following pancreaticoduodenectomies (14%, CI 6\u201025) and esophagectomies (13%, CI 4\u201027), but the greatest number of patients (30% (26\/88)) developed sepsis after a colorectal procedure. The most common infection sources were the abdomen (65% (57\/88)) and lungs\/mediastinum (22% (19\/88)), frequently polymicrobial (58% (36\/62) of patients with cultures). The incidence of insufficient empirical antibiotics was high (50% (30\/60)). The median ICU and hospital length\u2010of\u2010stay were 5.5 and 26\u00a0days and the 28\u2010day and 1\u2010year mortality rates were 16% (14\/88) and 41% (36\/87), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Incidence of sepsis following elective surgery is low in Iceland but mortality is high. Initial antimicrobial therapy needs careful consideration in these hospital\u2010acquired, often polymicrobial infections.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13747","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T11:20:09Z","timestamp":1605698409000},"page":"457-465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sepsis after elective surgery \u2013 Incidence, aetiology and outcome"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-652X","authenticated-orcid":false,"given":"Edda","family":"Vesteinsdottir","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Landspitali \u2013 The National University Hospital of Iceland Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Gottfredsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"},{"name":"Department of Infectious Diseases Landspitali \u2013 The National University Hospital of Iceland Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asbjorn","family":"Blondal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Akureyri Hospital Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7054-0844","authenticated-orcid":false,"given":"Martin I.","family":"Sigurdsson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Landspitali \u2013 The National University Hospital of Iceland Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0726-4378","authenticated-orcid":false,"given":"Sigurbergur","family":"Karason","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Landspitali \u2013 The National University Hospital of Iceland Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-2136-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4504-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7157"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0504-z"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000085141.75513.2B"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181dcf36e"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181cea3d0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1596-7"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2014.07.046"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2016.09.059"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei257"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318210f560"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.107"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.05.075"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.10.018"},{"key":"e_1_2_9_18_1","unstructured":"SigurgeirsdottirS.Health Systems in Transition \u2010 Iceland: Health system review. (2014) [www document]https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0018\/271017\/Iceland\u2010HiT\u2010web.pdf[accessed on August 11 2020]"},{"issue":"31","key":"e_1_2_9_19_1","first-page":"1250","article-title":"SCCM\/ESICM\/ACCP\/ATS\/SIS international sepsis definitions conference","volume":"2003","author":"Levy MM","year":"2001","journal-title":"Crit Care Med"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.06.017"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.10.007"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.11.042"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1192"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.06.040"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2799-y"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.06.020"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000375"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30398-X"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.09.002"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-013-2227-0"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4633-8"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199712000-00016"},{"key":"e_1_2_9_36_1","unstructured":"European Centre for Disease Prevention and Control.Surveillance of antimicrobial resistance in Europe2018. [www document]https:\/\/www.ecdc.europa.eu\/en\/publications\u2010data\/surveillance\u2010antimicrobial\u2010resistance\u2010europe\u20102018[accessed on July 28 2020]"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-121"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000098031.24329.10"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0087"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0087"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-003-1078-0"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.02023.x"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ1194"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23626"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13592"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02437.x"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-420"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13747","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.13747","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T12:45:51Z","timestamp":1693399551000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.13747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,29]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/aas.13747"],"URL":"https:\/\/doi.org\/10.1111\/aas.13747","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,29]]},"assertion":[{"value":"2020-09-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}