Dougnac Alberto L, Mercado Marcelo F, Cornejo Rodrigo R, Cariaga Mario V, Hernández Glenn P, Andresen Max H, Bugedo Guillermo T, Castillo Luis F
Departamento de Medicina Intensiva, Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2007 May;135(5):620-30. doi: 10.4067/s0034-98872007000500010. Epub 2007 Jul 9.
Severe sepsis (SS) is the leading cause of death in the Intensive Care Units (ICU).
To study the prevalence of SS in Chilean ICUs.
An observational, cross-sectional study using a predesigned written survey was done in all ICUs of Chile on April 21st, 2004. General hospital and ICU data and the number of hospitalized patients in the hospital and in the ICU at the survey day, were recorded. Patients were followed for 28 days.
Ninety four percent of ICUs participated in the survey. The ICU occupation index was 66%. Mean age of patients was 57.7+/-18 years and 59% were male, APACHE II score was 15+/-7.5 and SOFA score was 6+/-4. SS was the admission diagnosis of 94 of the 283 patients (33%) and 38 patients presented SS after admission. On the survey day, 112 patients fulfilled SS criteria (40%). APACHE II and SOFA scores were significantly higher in SS patients than in non SS patients. Global case-fatality ratio at 28 days was 15.9% (45/283). Case-fatality ratio in patients with or without SS at the moment of the survey was 26.7% (30/112) and 8.7% (17/171), respectively p <0.05. Thirteen percent of patients who developed SS after admission, died. Case-fatality ratios for patients with SS from Santiago and the other cities were similar, but APACHE II score was significantly higher in patients from Santiago. In SS patients, the independent predictors of mortality were SS as cause of hospital admission, APACHE II and SOFA scores. Ninety nine percent of SS patients had a known sepsis focus (48% respiratory and 30% abdominal). Eighty five patients that presented SS after admission, had a respiratory focus.
SS is highly prevalent in Chilean ICUs and represents the leading diagnosis at admission. SS as cause of hospitalization, APACHE II and SOFA scores were independent predictors of mortality.
严重脓毒症（SS）是重症监护病房（ICU）患者死亡的主要原因。
研究智利ICU中SS的患病率。
2004年4月21日，在智利所有ICU中开展了一项采用预先设计的书面调查问卷的观察性横断面研究。记录了综合医院和ICU的数据以及调查当日医院和ICU的住院患者数量。对患者进行了28天的随访。
94%的ICU参与了调查。ICU占用指数为66%。患者的平均年龄为57.7±18岁，男性占59%，急性生理与慢性健康状况评分系统（APACHE）II评分为15±7.5，序贯器官衰竭评估（SOFA）评分为6±4。在283例患者中，94例（33%）的入院诊断为SS，38例患者在入院后出现SS。在调查当日，112例患者符合SS标准（40%）。SS患者的APACHE II和SOFA评分显著高于非SS患者。28天的总体病死率为15.9%（45/283）。在调查时患有或未患有SS的患者病死率分别为26.7%（30/112）和8.7%（17/171），p<0.05。入院后发生SS的患者中有13%死亡。来自圣地亚哥和其他城市的SS患者病死率相似，但来自圣地亚哥的患者APACHE II评分显著更高。在SS患者中，死亡的独立预测因素为因SS入院、APACHE II和SOFA评分。99%的SS患者有已知的脓毒症病灶（48%为呼吸道，30%为腹部）。85例入院后出现SS的患者有呼吸道病灶。
SS在智利ICU中高度流行，是入院时的主要诊断。因SS入院、APACHE II和SOFA评分是死亡的独立预测因素。
