IMPRESS (International Multicentre PREvalence Study on Sepsis)

IMPRESS (International Multicentre PREvalence Study on Sepsis) is an observational study on sepsis and septic shock carried out by the European Society of Intensive Care (ESICM) and the Society of Critical Care Medicine (SCCM) under the framework of the Surviving Sepsis Campaign. Launched on World Sepsis Day, IMPRESS aims to determine the incidence and clinical patterns of septic syndromes on a single day in ICUs and Emergency Departments worldwide. Participating hospitals will collect data on November 7, 2013 using web-based and paper audit collection tools.


A decade ago, the Surviving Sepsis Campaign (SSC) was founded to set out clear diagnostic and treatment guidelines for patients with sepsis. The campaign has since succeeded in decreasing mortality by more than 25% in hospitals utilising the guidelines. However, we recognise that penetration of the SSC in all hospitals is incomplete, and adherence to the guidelines can be improved. We also recognise that the impact of the SSC may vary depending on the patient’s clinical trajectories and in different regions of the world. In order to improve patient outcomes, there is a need to better understand how patients presenting with sepsis are treated, how the individual elements of the bundles are used in different geographic areas and how these aspects may relate to outcome. This study has the following aims:

What are the aims of IMPRESS?

  • To determine the epidemiology of sepsis, severe sepsis and septic shock throughout the world.

  • To evaluate the impact of sepsis syndromes on outcome.

  • To evaluate the implementation of treatment guidelines recommended by SSC.

  • To estimate sample size requirements to detect meaningful differences in patient-centered outcomes for clinical trials performed in a large, international and collaborative research network.


Who can participate?

This international study encourages participation of centres with adult patients from as many countries as possible.


This one-day study will be performed on November 7th, 2013.

What are the inclusion and exclusion criteria?

For the study day (00h00 to 24h00), consecutive patients presenting to either the emergency department (ED) or ICUs (either intermediate care or intensive care) with severe sepsis or septic shock in participating sites will be enrolled.

To be eligible patients must have all of the following:

  • - Must be admitted or transferred to either the ED or an Intensive Care Unit.
  • - Have a high clinical suspicion of an infection
  • - Have sepsis as defined by
    • An infection together with two or more SIRS criteria
    • Evidence of acute organ dysfunction and / or shock

Patients with the following criteria will be excluded:

  • - Patients less than 18 years of age
  • - Patients in whom the sepsis has been present before the beginning of the study period
  • - Any patients previously included in the study during the same study period

What data is required?

De-identified patient-level data will be collected on patients presenting to a participating intensive care unit or emergency department with severe sepsis or septic shock over a 24 hour period from 00:00 to 24:00 on November 7, 2013. Data which is already collected as part of routine clinical care will be collected for this study. Data to be collected includes hospital and ICU characteristics, patient characteristics, severity of illness, adherence to SSC bundle elements, and mortality. It will take between 30-45 minutes to collect and enter data for each patient admitted during the 24 hours study period with severe sepsis or septic shock.

Do I need IRB approval?

This is a prospective observational quality improvement project. Ethics approval may or may not be required depending on what country your ICU is located. IRB approval must be obtained for each centre if required by its local regulations. In most countries, a National coordinator will liaise with participating centres and indicate the process required regarding obtention of IRB approval. * IRB NOTE: A leading U.S. academic medical center has determined the IMPRESS study to be a quality assurance project and does not involve patient research. Approval has been granted. Participating hospitals are encouraged to review the protocol provided on the IMPRESS site to describe the data collection criteria to their own internal review or administrative leadership for approval to participate.
UK ethics letter response

How do I register?

Units of all sizes in all geographical locations around the world are required. If you would like to register your centre or your unit, please submit your registration here.