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Methods: The SSC was introduced into more than 200 sites in Europe and the USA. All patients identifi ed with severe sepsis and septic shock in emergency departments or hospital wards and admitted to intensive care units (ICUs), and those with sepsis in ICUs were entered into the SSC database. Patients entered into the database from its launch in January, 2005, through January, 2010, in units with at least 20 patients and 3 months of enrolment of patients were included in this analysis. Patients included in the cohort were limited to those entered in the fi rst 4 years at every site.We used random-eff ects logistic regression to estimate the hospital mortality odds ratio (OR) for Europe relative to the USA. We used random-eff ects linear regression to fi nd the relation between lengths of stay in hospital and ICU and geographic region.
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