Harrison David A, Welch Catherine A, Eddleston Jane M
Intensive Care National Audit & Research Centre (ICNARC), Tavistock House, Tavistock Square, London WC1H 9HR, UK.
Crit Care. 2006;10(2):R42. doi: 10.1186/cc4854.
To evaluate the impact of recent evidence-based treatments for severe sepsis in routine clinical care requires an understanding of the underlying epidemiology, particularly with regard to trends over time. We interrogated a high quality clinical database to examine trends in the incidence and mortality of severe sepsis over a nine-year period.
Admissions with severe sepsis occurring at any time within 24 hours of admission to critical care were identified to an established methodology using raw physiological data from the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme Database, containing data from 343,860 admissions to 172 adult, general critical care units in England, Wales and Northern Ireland between December 1995 and January 2005. Generalised linear models were used to assess changes in the incidence, case mix, outcomes and activity of these admissions.
In total, 92,672 admissions (27.0%) were identified as having severe sepsis in the first 24 hours following admission. The percentage of admissions with severe sepsis during the first 24 hours rose from 23.5% in 1996 to 28.7% in 2004. This represents an increase from an estimated 18,500 to 31,000 admissions to all 240 adult, general critical care units in England, Wales and Northern Ireland. Hospital mortality for admissions with severe sepsis decreased from 48.3% in 1996 to 44.7% in 2004, but the total number of deaths increased from an estimated 9,000 to 14,000. The treated incidence of severe sepsis per 100,000 population rose from 46 in 1996 to 66 in 2003, with the associated number of hospital deaths per 100,000 population rising from 23 to 30.
The population incidence of critical care admission with severe sepsis during the first 24 hours and associated hospital deaths are increasing. These baseline data provide essential information to those wishing to evaluate the introduction of the Surviving Sepsis Campaign care bundles in UK hospitals.
要评估近期基于证据的严重脓毒症治疗方法在常规临床护理中的影响，需要了解其潜在的流行病学情况，尤其是随时间的趋势。我们查阅了一个高质量的临床数据库，以研究九年间严重脓毒症的发病率和死亡率趋势。
利用重症监护国家审计与研究中心（ICNARC）病例组合项目数据库中的原始生理数据，通过既定方法确定在重症监护入院后24小时内任何时间发生严重脓毒症的入院病例。该数据库包含1995年12月至2005年1月期间英格兰、威尔士和北爱尔兰172个成人普通重症监护病房的343,860例入院病例数据。采用广义线性模型评估这些入院病例的发病率、病例组合、结局和活动的变化。
总共92,672例入院病例（27.0%）在入院后的头24小时内被确定为患有严重脓毒症。入院后头2小时内患有严重脓毒症的入院病例百分比从1996年的23.5%上升至2004年的28.7%。这意味着在英格兰、威尔士和北爱尔兰所有240个成人普通重症监护病房中，估计入院病例从18,500例增加到31,000例。严重脓毒症入院病例的医院死亡率从1996年的48.3%降至2004年的44.7%，但死亡总数从估计的9,000例增加到14,000例。每10万人口中严重脓毒症的治疗发病率从1996年的46例上升至2003年的66例，每10万人口中相关的医院死亡人数从23例上升至30例。
在头24小时内因严重脓毒症入住重症监护病房的人群发病率及相关医院死亡人数正在增加。这些基线数据为那些希望评估英国医院引入“拯救脓毒症运动”护理包的人提供了重要信息。
Zotero 插件
