Cheng Baoli, Xie Guohao, Yao ShangLong, Wu Xinmin, Guo Qulian, Gu Miaoning, Fang Qiang, Xu Qiuping, Wang Dongxin, Jin Yuhong, Yuan ShiYing, Wang Junlu, Du Zhaohui, Sun Yunbo, Fang XiangMing
Department of Anesthesiology, Intensive Care Unit, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Crit Care Med. 2007 Nov;35(11):2538-46. doi: 10.1097/01.CCM.0000284492.30800.00.
To determine the occurrence rate, outcomes, and the characteristics of severe sepsis in surgical intensive care units in multiple medical centers within China and to assess the cost and resource use of severe sepsis in China.
Prospective, observational study of surgical intensive care unit patients at ten university hospitals in six provinces in China.
All adult admissions in studied intensive care units from December 1, 2004, to November 30, 2005.
None.
The criteria of severe sepsis were based on the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definition. Analysis of data from 3,665 intensive care unit admissions identified 318 (8.68%) cases of severe sepsis, 64.8% of which were men. The median age (interquartile range) of patients with severe sepsis was 64 (47-74) yrs. Microbes had been isolated from 228 (71.7%) patients, including 171 (53.8%) with Gram-negative bacteria and 146 (45.9%) with Gram-positive bacteria. A total of 90 (22.0%) patients had invasive fungal infection, 20 (6.3%) of which had fungemia. The abdomen was the most common site of infections (72.3%), followed by lung (52.8%). The overall hospital mortality of severe sepsis was 48.7%. Risk factors for hospital mortality included age, chronic comorbidity of malignant neoplasm, Gram-positive bacterial infection, invasive fungal infection, admission Acute Physiology Score, and admission Sequential Organ Failure Assessment score of respiratory dysfunction and cardiovascular dysfunction. The median Therapeutic Intervention Scoring System-28 score was 43 (38-49). The mean hospital cost was $11,390 per patient and $502 per patient per day.
Severe sepsis is a common, expensive, and frequently fatal syndrome in critically ill surgical patients in China. Other than the microbiological patterns, the incidence, mortality, and major characteristics of severe sepsis in Chinese surgical intensive care units are close to those documented in developed countries.
确定中国多个医疗中心外科重症监护病房中严重脓毒症的发生率、转归及特征，并评估中国严重脓毒症的成本和资源利用情况。
对中国六个省份十所大学医院的外科重症监护病房患者进行前瞻性观察研究。
2004年12月1日至2005年11月30日期间入住所研究重症监护病房的所有成年患者。
无。
严重脓毒症的诊断标准基于美国胸科医师学会/危重病医学会共识会议的定义。对3665例重症监护病房入院患者的数据进行分析，确定了318例（8.68%）严重脓毒症病例，其中64.8%为男性。严重脓毒症患者的年龄中位数（四分位间距）为64岁（47 - 74岁）。228例（71.7%）患者分离出微生物，其中171例（53.8%）为革兰阴性菌，146例（45.9%）为革兰阳性菌。共有90例（22.0%）患者发生侵袭性真菌感染，其中20例（6.3%）有真菌血症。腹部是最常见的感染部位（72.3%），其次是肺部（52.8%）。严重脓毒症患者的总体医院死亡率为48.7%。医院死亡的危险因素包括年龄、恶性肿瘤慢性合并症、革兰阳性菌感染、侵袭性真菌感染、入院时急性生理评分以及入院时呼吸功能和心血管功能的序贯器官衰竭评估评分。治疗干预评分系统-28评分的中位数为43分（38 - 49分）。平均每位患者的住院费用为11390美元，每位患者每天的费用为502美元。
在中国，严重脓毒症是重症外科患者中一种常见、昂贵且常致命的综合征。除微生物模式外，中国外科重症监护病房中严重脓毒症的发病率、死亡率及主要特征与发达国家报道的相近。
