{"id":18223,"date":"2020-01-31T05:49:34","date_gmt":"2020-01-30T21:49:34","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=18223"},"modified":"2020-02-28T06:12:38","modified_gmt":"2020-02-27T22:12:38","slug":"18223","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=18223","title":{"rendered":"[Crit Care Med\u5728\u7ebf\u53d1\u8868]\uff1a\u4e2d\u56fdICU\u4e2d\u8113\u6bd2\u75c7\u7684\u6d41\u884c\u75c5\u5b66"},"content":{"rendered":"\n

The Epidemiology of Sepsis in Chinese ICUs: A National Cross-Sectional Survey<\/h1>\n\n\n\n

Xie Jianfeng, Wang Hongliang, Kang Yan, et al <\/h3>\n\n\n\n

Crit Care Med: December 5, 2019<\/a> doi: 10.1097\/CCM.0000000000004155<\/h3>\n\n\n\n

Abstract<\/h1>\n\n\n\n

Objectives:\u00a0\u76ee\u7684<\/h3>\n\n\n\n

We performed a national cross-sectional survey to determine the epidemiologic characteristics of patients with\u00a0sepsis\u00a0in ICU in China.<\/p>\n\n\n\n

\u901a\u8fc7\u8fdb\u884c\u5168\u56fd\u6027\u6a2a\u65ad\u9762\u8c03\u67e5\uff0c\u4ee5\u660e\u786e\u4e2d\u56fdICU\u5185\u8113\u6bd2\u75c7\u7684\u6d41\u884c\u75c5\u5b66\u7279\u5f81\u3002<\/p>\n\n\n\n

Design:\u00a0\u8bd5\u9a8c\u8bbe\u8ba1<\/h3>\n\n\n\n

A cross-section survey study.<\/p>\n\n\n\n

\u6a2a\u65ad\u9762\u8c03\u67e5\u7814\u7a76<\/p>\n\n\n\n

Setting:\u00a0\u573a\u666f<\/h3>\n\n\n\n

Forty-four hospitals in mainland China from December 1, 2015, to January 31, 2016.<\/p>\n\n\n\n

\u4e2d\u56fd\u5927\u9646\u5730\u533a44\u5bb6\u533b\u9662\uff0c\u8c03\u67e5\u65f6\u95f4\u4e3a2015\u5e7412\u67081\u65e5\u81f32016\u5e741\u670831\u65e5<\/p>\n\n\n\n

Patients:\u00a0\u7814\u7a76\u5bf9\u8c61<\/h3>\n\n\n\n

All septic patients diagnosed according\u00a0sepsis-1 criteria admitted to participating ICU.<\/p>\n\n\n\n

\u7814\u7a76\u671f\u95f4\u5165\u4f4fICU\u6240\u6709\u7b26\u5408Sepsis-1.0\u8bca\u65ad\u6807\u51c6\u7684\u65b0\u53d1\u8113\u6bd2\u75c7\u60a3\u8005<\/p>\n\n\n\n

Interventions:\u00a0\u5e72\u9884\u63aa\u65bd<\/h3>\n\n\n\n

None.<\/p>\n\n\n\n

\u65e0<\/p>\n\n\n\n

Measurements and Main Results:\u00a0\u6d4b\u5b9a\u6307\u6807\u4e0e\u4e3b\u8981\u7ed3\u679c<\/h3>\n\n\n\n

We recorded demographic, physiologic, and microbiological data with follow-up for 90 days or death, if sooner. The frequency of\u00a0sepsis\u00a0and 90-day\u00a0mortality\u00a0rate were computed, and the relationship with gross domestic product determined. Multivariate logistic regression analysis was used to determine risk factors for 90-day\u00a0mortality\u00a0in patients with\u00a0sepsis. Two-thousand three-hundred twenty-two patients with\u00a0sepsis\u00a0were included in the analysis, of whom 786 patients (33.9%) had hospital-acquired\u00a0sepsis. The most common infection site was the lung (68.2%), followed by abdomen (26.6%) and bloodstream (7.8%). The frequency of\u00a0sepsis\u00a0in the ICU was 20.6 cases per 100 ICU admissions (95% CI, 15.8\u201325.4) with a 90-day\u00a0mortality\u00a0of 35.5%. The proportion of\u00a0sepsis, severe\u00a0sepsis, and septic shock were 3.10%, 43.6%, and 53.3% with a 90-day\u00a0mortality\u00a0of 2.78%, 17.69%, and 51.94%, respectively. Older age, low body weight, higher Sequential Organ Failure Assessment score, the number of systemic inflammatory response syndrome criteria, comorbid with heart failure, hematologic cancer, immunosuppression, higher level of lactate, infection site (pneumonia and bloodstream) were associated with 90-day\u00a0mortality.<\/p>\n\n\n\n

\u8bb0\u5f55\u60a3\u8005\u968f\u8bbf90\u5929\u5185\u6216\u81f3\u6b7b\u4ea1\uff08\u5982\u679c\u5c11\u4e8e90\u5929\uff09\u7684\u4eba\u53e3\u4fe1\u606f\u5b66\u3001\u751f\u7406\u6307\u6807\u548c\u5fae\u751f\u7269\u5b66\u6570\u636e\u3002\u8ba1\u7b97\u8113\u6bd2\u75c7\u7684\u53d1\u75c5\u7387\u548c90\u5929\u75c5\u6b7b\u7387\uff0c\u5e76\u786e\u5b9a\u5176\u4e0e\u56fd\u5185\u751f\u4ea7\u603b\u503c(GDP)\u7684\u5173\u7cfb\u3002\u4f7f\u7528\u591a\u56e0\u7d20logistic\u56de\u5f52\u5206\u6790\u5224\u65ad\u8113\u6bd2\u75c7\u60a3\u800590\u5929\u75c5\u6b7b\u7387\u7684\u5371\u9669\u56e0\u7d20\u30022,322\u4f8b\u8113\u6bd2\u75c7\u60a3\u8005\u7eb3\u5165\u5206\u6790\uff0c\u5176\u4e2d\u533b\u9662\u83b7\u5f97\u6027\u8113\u6bd2\u75c7786\u4f8b(33.9%)\u3002\u6700\u5e38\u89c1\u7684\u611f\u67d3\u90e8\u4f4d\u662f\u80ba\u90e8(68.2%)\uff0c\u5176\u6b21\u662f\u8179\u90e8(26.6%)\u548c\u8840\u6db2(7.8%)\u3002ICU\u5185\u8113\u6bd2\u75c7\u7684\u53d1\u75c5\u7387\u4e3a20.6% (95% CI, 15.8-25.4)\uff0c90\u5929\u75c5\u6b7b\u7387\u4e3a35.5%\u3002\u8113\u6bd2\u75c7\u3001\u4e25\u91cd\u8113\u6bd2\u75c7\u548c\u611f\u67d3\u6027\u4f11\u514b\u7684\u6bd4\u4f8b\u5206\u522b\u4e3a3.10%\u300143.6%\u548c53.3%\uff0c90\u5929\u75c5\u6b7b\u7387\u5206\u522b\u4e3a2.78%\u300117.69%\u548c51.94%\u3002\u9ad8\u9f84\u3001\u4f4e\u4f53\u91cd\u3001SOFA\u8bc4\u5206\u8f83\u9ad8\u3001\u5168\u8eab\u708e\u75c7\u53cd\u5e94\u7efc\u5408\u5f81\u6807\u51c6\u6570\u3001\u5408\u5e76\u5fc3\u529b\u8870\u7aed\u3001\u8840\u6db2\u80bf\u7624\u3001\u514d\u75ab\u6291\u5236\u3001\u9ad8\u4e73\u9178\u6c34\u5e73\u3001\u611f\u67d3\u90e8\u4f4d\uff08\u80ba\u708e\u548c\u8840\u6db2\uff09\u4e0e90\u5929\u75c5\u6b7b\u7387\u76f8\u5173\u3002<\/p>\n\n\n\n

Conclusions:\u00a0\u7ed3\u8bba<\/h3>\n\n\n\n

Sepsis\u00a0affects a fifth of patients admitted to ICUs in mainland China with a 90-day\u00a0mortality\u00a0rate of 35.5%. Our findings indicate that a large burden of\u00a0sepsis, and we need to focus on\u00a0sepsis\u00a0as a quality improvement target in China given the high\u00a0mortality. In addition, further studies are needed to delineate the\u00a0epidemiology\u00a0of\u00a0sepsis\u00a0outside the ICU.<\/p>\n\n\n\n

\u8113\u6bd2\u75c7\u5f71\u54cd\u4e86\u4e2d\u56fd\u5927\u9646\u4e94\u5206\u4e4b\u4e00\u7684ICU\u60a3\u8005\uff0c90\u5929\u75c5\u6b7b\u7387\u4e3a35.5%\u3002\u672c\u7814\u7a76\u7ed3\u679c\u63d0\u793a\uff0c\u9274\u4e8e\u6211\u56fd\u8113\u6bd2\u75c7\u7684\u9ad8\u53d1\u75c5\u7387\u3001\u9ad8\u75c5\u6b7b\u7387\u53ca\u9ad8\u533b\u7597\u82b1\u8d39\uff0c\u672a\u6765\u9700\u8981\u8fdb\u4e00\u6b65\u63a8\u8fdb\u8113\u6bd2\u75c7\u7684\u8bca\u7597\u63aa\u65bd\u6539\u8fdb\u3002<\/a>\u6b64\u5916\uff0c\u672a\u6765\u8fd8\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u7814\u7a76\u6765\u660e\u786e\u5728ICU\u5916\u7684\u8113\u6bd2\u75c7\u6d41\u884c\u75c5\u5b66\u60c5\u51b5\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

The Epidemiology of Sepsis in Chine […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18223"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=18223"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18223\/revisions"}],"predecessor-version":[{"id":18252,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18223\/revisions\/18252"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=18223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=18223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}