The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

Overview of attention for article published in JAMA: Journal of the American Medical Association, February 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#6 of 18,617)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

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2630 Mendeley
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2 CiteULike
Title
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Published in
JAMA: Journal of the American Medical Association, February 2016
DOI 10.1001/jama.2016.0287
Pubmed ID
Authors

Mervyn Singer, Clifford S. Deutschman, Christopher Warren Seymour, Manu Shankar-Hari, Djillali Annane, Michael Bauer, Rinaldo Bellomo, Gordon R. Bernard, Jean-Daniel Chiche, Craig M. Coopersmith, Richard S. Hotchkiss, Mitchell M. Levy, John C. Marshall, Greg S. Martin, Steven M. Opal, Gordon D. Rubenfeld, Tom van der Poll, Jean-Louis Vincent, Derek C. Angus, Singer, Mervyn, Deutschman, Clifford S, Seymour, Christopher Warren, Shankar-Hari, Manu, Annane, Djillali, Bauer, Michael, Bellomo, Rinaldo, Bernard, Gordon R, Chiche, Jean-Daniel, Coopersmith, Craig M, Hotchkiss, Richard S, Levy, Mitchell M, Marshall, John C, Martin, Greg S, Opal, Steven M, Rubenfeld, Gordon D, van der Poll, Tom, Vincent, Jean-Louis, Angus, Derek C

Abstract

Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. To evaluate and, as needed, update definitions for sepsis and septic shock. A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment). Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant. Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less. These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis.

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Mendeley readers

The data shown below were compiled from readership statistics for 2,630 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 20 <1%
United States 14 <1%
Brazil 13 <1%
Italy 11 <1%
Germany 10 <1%
Spain 10 <1%
United Kingdom 10 <1%
Canada 6 <1%
Denmark 5 <1%
Other 51 2%
Unknown 2480 94%

Demographic breakdown

Readers by professional status Count As %
Researcher 394 15%
Other 390 15%
Student > Postgraduate 368 14%
Student > Bachelor 335 13%
Student > Master 327 12%
Other 816 31%
Readers by discipline Count As %
Medicine and Dentistry 2134 81%
Agricultural and Biological Sciences 144 5%
Nursing and Health Professions 64 2%
Pharmacology, Toxicology and Pharmaceutical Science 50 2%
Biochemistry, Genetics and Molecular Biology 49 2%
Other 189 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 2501. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 March 2017.
All research outputs
#117
of 7,460,420 outputs
Outputs from JAMA: Journal of the American Medical Association
#6
of 18,617 outputs
Outputs of similar age
#12
of 285,525 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#1
of 421 outputs
Altmetric has tracked 7,460,420 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 18,617 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 33.6. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 285,525 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 421 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.