ConclusionsIn summary, our results show that a large-scale cohort of septic shock patients is feasible reference using simplified computer-based data collection, and shows that mortality among this patient group is still very high. This can be explained by the fact that patients with septic shock admitted to the ICU are generally older, with more co-morbidities, a worse previous state of health, and requiring more life-support therapies. These observations may be useful for quality improvement of the care provided to patients at risk of, or with confirmed septic shock, for the design of future clinical studies and for healthcare decision-makers.Key messages? This is the first large-scale epidemiological study performed in France since the publication of the Surviving Sepsis Campaign recommendations and of French national guidelines for the management of septic shock.

? Mortality in the ICU among patients admitted for septic shock is declining, or rather, death occurs at a later stage. In-hospital mortality has remained constant for many years, likely due to better initial management.? The older age, greater dependency, and more frequent co-morbidities among ICU patients admitted for septic shock probably also explain why overall mortality has remained stable over time.? Mortality at 28 days after an initial episode of septic shock in the ICU was 42% in this prospective, multicenter, cohort study from 14 ICUs in 10 public hospitals in France. Main factors significantly associated with time to death, right censored at 28 days were age, Knaus, and SOFA scores.

AbbreviationsICU: Intensive Care Unit; IQR: interquartile range; SAPS II: Simplified Acute Physiological Score II; SD: standard deviation; SOFA: Sepsis-related Organ Failure Assessment.Competing interestsThe authors declare that Carfilzomib they have no competing interests.Authors’ contributionsStudy conception and design: JPQ, CB, AP; Data acquisition: All authors; Study coordination: VC, JC, GL, PP, AN; Statistical analysis: JPQ, CB, AP; Drafting of the manuscript: JPQ, CB, AP, FG, JCN; Critical revision of the manuscript: All; Final approval of the manuscript for submission: All.AcknowledgementsThe authors thank Fiona Ecarnot for translation and editorial assistance and Amel Mahboubi for help with the statistical analysis.