The dynamics of disease progression in sepsis: Markov modeling describing the natural history and the likely impact of effective antisepsis agents.


Journal Article

We conducted a 9-month prospective cohort study of 2,527 patients with systemic inflammatory response syndrome in three intensive care units and three general wards in a tertiary health care institution. Markov models were developed to predict the probability of movement to and from more severe stages--sepsis, severe sepsis, or septic shock--at 1, 3, and 7 days. For patients with sepsis, severe sepsis, and septic shock, the probabilities of remaining in the same category after 1 day were .65, .68, and .61, respectively. The probability for progression after 1 day was .09 for sepsis to severe sepsis and .026 for severe sepsis to shock. The probability of patients with sepsis, severe sepsis, and septic shock dying after 1 day was .005, .009, and .079, respectively. The model can be used to predict the reduction in end organ dysfunction and mortality with use of increasingly effective antisepsis agents.

Full Text

Cited Authors

  • Rangel-Frausto, MS; Pittet, D; Hwang, T; Woolson, RF; Wenzel, RP

Published Date

  • July 1998

Published In

Volume / Issue

  • 27 / 1

Start / End Page

  • 185 - 190

PubMed ID

  • 9675475

Pubmed Central ID

  • 9675475

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

International Standard Serial Number (ISSN)

  • 1058-4838

Digital Object Identifier (DOI)

  • 10.1086/514630


  • eng