{"id":18238,"date":"2020-01-19T05:26:00","date_gmt":"2020-01-18T21:26:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=18238"},"modified":"2020-02-28T06:13:38","modified_gmt":"2020-02-27T22:13:38","slug":"lancet%e6%9c%80%e6%96%b0%e8%ae%ba%e6%96%87%ef%bc%9a1990%e5%b9%b4%e8%87%b32017%e5%b9%b4%e5%85%a8%e7%90%83%e3%80%81%e5%9c%b0%e5%8c%ba%e5%8f%8a%e5%9b%bd%e5%ae%b6%e8%84%93%e6%af%92%e7%97%87%e5%8f%91","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=18238","title":{"rendered":"[Lancet\u6700\u65b0\u8bba\u6587]\uff1a1990\u5e74\u81f32017\u5e74\u5168\u7403\u3001\u5730\u533a\u53ca\u56fd\u5bb6\u8113\u6bd2\u75c7\u53d1\u75c5\u7387\u53ca\u6b7b\u4ea1\u7387\uff1a\u5168\u7403\u75be\u75c5\u8d1f\u62c5\u7814\u7a76\u7684\u5206\u6790"},"content":{"rendered":"\n

Global, regional, and national sepsis incidence and mortality, 1990\u20132017: analysis for the Global Burden of Disease Study<\/h1>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background \u80cc\u666f<\/h3>\n\n\n\n

Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. It is considered a major cause of health loss, but data for the global burden of sepsis are limited. As a syndrome caused by underlying infection, sepsis is not part of standard Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimates. Accurate estimates are important to inform and monitor health policy interventions, allocation of resources, and clinical treatment initiatives. We estimated the global, regional, and national incidence of sepsis and mortality from this disorder using data from GBD 2017.<\/p>\n\n\n\n

\u8113\u6bd2\u75c7\u662f\u611f\u67d3\u5f15\u8d77\u7684\u5bbf\u4e3b\u53cd\u5e94\u5931\u8c03\u5bfc\u81f4\u7684\u81f4\u547d\u6027\u5668\u5b98\u529f\u80fd\u969c\u788d\u3002\u8113\u6bd2\u75c7\u662f\u5f15\u53d1\u5065\u5eb7\u635f\u5bb3\u7684\u91cd\u8981\u539f\u56e0\uff0c\u4f46\u6709\u5173\u5168\u7403\u8113\u6bd2\u75c7\u8d1f\u62c5\u7684\u6570\u636e\u975e\u5e38\u6709\u9650\u3002\u4f5c\u4e3a\u611f\u67d3\u5f15\u8d77\u7684\u4e00\u79cd\u4e34\u5e8a\u7efc\u5408\u5f81\uff0c\u8113\u6bd2\u75c7\u5e76\u975e\u6807\u51c6\u5168\u7403\u75be\u75c5\u3001\u521b\u4f24\u53ca\u5371\u9669\u56e0\u7d20\u8d1f\u62c5(GBD)\u7814\u7a76\u7684\u4e00\u90e8\u5206\u3002\u51c6\u786e\u7684\u4f30\u8ba1\u5bf9\u4e8e\u536b\u751f\u5e72\u9884\u653f\u7b56\u7684\u5236\u5b9a\u4e0e\u5b9e\u65bd\uff0c\u8d44\u6e90\u5206\u914d\uff0c\u4e34\u5e8a\u6cbb\u7597\u7b49\u975e\u5e38\u91cd\u8981\u3002\u6211\u4eec\u91c7\u7528GBD 2017\u7684\u6570\u636e\uff0c\u5bf9\u5168\u7403\u3001\u5730\u533a\u548c\u56fd\u5bb6\u8113\u6bd2\u75c7\u53d1\u75c5\u7387\u53ca\u6b7b\u4ea1\u7387\u8fdb\u884c\u4e86\u4f30\u7b97\u3002<\/p>\n\n\n\n

Methods \u65b9\u6cd5<\/h3>\n\n\n\n

We used multiple cause-of-death data from 109 million individual death records to calculate mortality related to sepsis among each of the 282 underlying causes of death in GBD 2017. The percentage of sepsis-related deaths by underlying GBD cause in each location worldwide was modelled using mixed-effects linear regression. Sepsis-related mortality for each age group, sex, location, GBD cause, and year (1990\u20132017) was estimated by applying modelled cause-specific fractions to GBD 2017 cause-of-death estimates. We used data for 8\u00b77 million individual hospital records to calculate in-hospital sepsis-associated case-fatality, stratified by underlying GBD cause. In-hospital sepsis-associated case-fatality was modelled for each location using linear regression, and sepsis incidence was estimated by applying modelled case-fatality to sepsis-related mortality estimates.<\/p>\n\n\n\n

\u6839\u636e1\u4ebf9\u767e\u4e07\u4eba\u6b7b\u4ea1\u8bb0\u5f55\u4e2d\u7684\u591a\u6b7b\u56e0\u6570\u636e\uff0c\u6211\u4eec\u5bf9GBD 2017\u4e2d282\u79cd\u6b7b\u56e0\u7684\u6bcf\u79cd\u6b7b\u56e0\uff0c\u8ba1\u7b97\u8113\u6bd2\u75c7\u76f8\u5173\u6b7b\u4ea1\u7387\u3002\u5bf9\u5168\u7403\u6bcf\u4e2a\u5730\u533a\u57fa\u7840GBD\u6b7b\u56e0\u4e2d\u8113\u6bd2\u75c7\u76f8\u5173\u6b7b\u4ea1\u7684\u767e\u5206\u6bd4\u91c7\u7528\u6df7\u5408\u6548\u5e94\u7ebf\u6027\u56de\u5f52\u5efa\u6a21\u3002\u5bf9\u4e8e\u5404\u5e74\u9f84\u7ec4\u3001\u6027\u522b\u3001\u5730\u70b9\u3001GBD\u6b7b\u56e0\u53ca\u5e74\u4efd(1990\u20132017)\uff0c\u91c7\u7528\u5efa\u6a21\u7684\u6b7b\u56e0\u7279\u5f02\u6027\u5206\u6570\uff0c\u6839\u636eGBD 2017\u6b7b\u56e0\u6570\u636e\u8ba1\u7b97\u8113\u6bd2\u75c7\u76f8\u5173\u6b7b\u4ea1\u7387\u3002\u6211\u4eec\u4f7f\u7528870\u4e07\u4eba\u4f4f\u9662\u75c5\u4f8b\u6570\u636e\u8ba1\u7b97\u8113\u6bd2\u75c7\u76f8\u5173\u4f4f\u9662\u75c5\u6b7b\u7387\uff0c\u5e76\u6839\u636e\u57fa\u7840GBD\u6b7b\u56e0\u5206\u5c42\u3002\u5bf9\u4e8e\u6bcf\u4e2a\u5730\u533a\u91c7\u7528\u7ebf\u6027\u56de\u5f52\u5bf9\u8113\u6bd2\u75c7\u76f8\u5173\u4f4f\u9662\u75c5\u6b7b\u7387\u5efa\u6a21\uff0c\u5e76\u5c06\u5efa\u6a21\u7684\u75c5\u6b7b\u7387\u7ed3\u5408\u8113\u6bd2\u75c7\u76f8\u5173\u6b7b\u4ea1\u7387\u6570\u636e\u4f30\u7b97\u8113\u6bd2\u75c7\u53d1\u75c5\u7387\u3002<\/p>\n\n\n\n

Findings \u7ed3\u679c<\/h3>\n\n\n\n

In 2017, an estimated 48\u00b79 million (95% uncertainty interval [UI] 38\u00b79\u201362\u00b79) incident cases of sepsis were recorded worldwide and 11\u00b70 million (10\u00b71\u201312\u00b70) sepsis-related deaths were reported, representing 19\u00b77% (18\u00b72\u201321\u00b74) of all global deaths. Age-standardised sepsis incidence fell by 37\u00b70% (95% UI 11\u00b78\u201354\u00b75) and mortality decreased by 52\u00b78% (47\u00b77\u201357\u00b75) from 1990 to 2017. Sepsis incidence and mortality varied substantially across regions, with the highest burden in sub-Saharan Africa, Oceania, south Asia, east Asia, and southeast Asia.<\/p>\n\n\n\n

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\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Interpretation \u7ed3\u8bba<\/h3>\n\n\n\n

Despite declining age-standardised incidence and mortality, sepsis remains a major cause of health loss worldwide and has an especially high health-related burden in sub-Saharan Africa.<\/p>\n\n\n\n

\u5c3d\u7ba1\u5e74\u9f84\u6807\u5316\u53d1\u75c5\u7387\u4e0e\u6b7b\u4ea1\u7387\u5747\u964d\u4f4e\uff0c\u4f46\u8113\u6bd2\u75c7\u4ecd\u7136\u662f\u5a01\u80c1\u5168\u7403\u5065\u5eb7\u7684\u91cd\u8981\u75c5\u56e0\uff0c\u5c24\u5176\u5728\u6492\u54c8\u62c9\u4ee5\u5357\u975e\u6d32\u5730\u533a\u9020\u6210\u975e\u5e38\u9ad8\u7684\u5065\u5eb7\u76f8\u5173\u8d1f\u62c5\u3002<\/p>\n\n\n\n

Funding \u8d44\u52a9<\/h3>\n\n\n\n

The Bill & Melinda Gates Foundation, the National Institutes of Health, the University of Pittsburgh, the British Columbia Children\u2019s Hospital Foundation, the Wellcome Trust, and the Fleming Fund.<\/p>\n","protected":false},"excerpt":{"rendered":"

Global, regional, and national sepsis incidence and mor […]<\/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\/18238"}],"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=18238"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18238\/revisions"}],"predecessor-version":[{"id":18247,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18238\/revisions\/18247"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18238"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=18238"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=18238"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}