Beale R, Reinhart K, Brunkhorst F M, Dobb G, Levy M, Martin G, Martin C, Ramsey G, Silva E, Vallet B, Vincent J-L, Janes J M, Sarwat S, Williams M D
Adult Intensive Care Unit, Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Lambeth Palace Road, SE1 7EH, London, UK.
Infection. 2009 Jun;37(3):222-32. doi: 10.1007/s15010-008-8203-z. Epub 2009 Apr 28.
The PROGRESS Registry (Promoting Global Research Excellence in Severe Sepsis) was designed to provide comparative data reflecting everyday clinical practice, thereby allowing participating institutions to explore and benchmark medical interventions in severe sepsis.
PROGRESS was an international, noninterventional, prospective, observational registry collecting data that describe the management and outcomes of severe sepsis patients in intensive care units (ICUs). Patients were enrolled who had been diagnosed with severe sepsis (suspected or proven infection and >or= 1 acute sepsis-induced organ dysfunction) at the participating institutions, where de-identified data were entered directly into a secured website. PROGRESS was governed by an independent international medical advisory board.
PROGRESS took place in 276 ICUs in 37 countries, and 12,881 patients were identified as having severe sepsis. There was considerable variation among countries in enrollment levels, provision of standard treatment and supportive therapies, and ICU and hospital outcomes. Eight countries accounted for 65.2% of the enrolled patients. Males (59.3%) and Caucasian (48.6%) patients predominated the patient cohort. Diagnosis of severe sepsis was prior to ICU admission in 45.7% of patients, at ICU admission in 29.1% of patients, and after ICU admission in the remainder. Globally, ICU and hospital mortality rates were 39.2% and 49.6%, respectively. The mean length of ICU and hospital stay was 14.6 days and 28.2 days, respectively.
The PROGRESS international sepsis registry demonstrates that a large web-based sepsis registry is feasible. Wide variations in outcomes and use of sepsis therapies were observed between countries. These results also suggest that additional opportunities exist across countries to improve severe sepsis outcomes.
PROGRESS注册研究（促进全球严重脓毒症研究卓越性）旨在提供反映日常临床实践的比较数据，从而使参与机构能够探索和衡量严重脓毒症的医学干预措施。
PROGRESS是一项国际性、非干预性、前瞻性观察性注册研究，收集描述重症监护病房（ICU）中严重脓毒症患者管理和结局的数据。在参与机构中，纳入已被诊断为严重脓毒症（疑似或确诊感染且≥1项急性脓毒症诱发的器官功能障碍）的患者，经过去识别处理的数据直接录入一个安全的网站。PROGRESS由一个独立的国际医学顾问委员会管理。
PROGRESS在37个国家的276个ICU中开展，12881例患者被确定为患有严重脓毒症。各国在入组水平、标准治疗和支持性治疗的提供以及ICU和医院结局方面存在相当大的差异。8个国家的入组患者占总数的65.2%。患者队列中男性（59.3%）和白种人（48.6%）占主导。45.7%的患者在入住ICU之前被诊断为严重脓毒症，29.1%的患者在入住ICU时被诊断，其余患者在入住ICU之后被诊断。全球范围内，ICU死亡率和医院死亡率分别为39.2%和49.6%。ICU平均住院时间和医院平均住院时间分别为14.6天和28.2天。
PROGRESS国际脓毒症注册研究表明，基于网络的大型脓毒症注册研究是可行的。各国之间在脓毒症治疗结局和治疗方法的使用上存在很大差异。这些结果还表明，各国在改善严重脓毒症结局方面还有更多机会。
