Carrillo-Esper Raúl, Carrillo-Córdova Jorge Raúl, Carrillo-Córdova Luis Daniel
Unidad de Terapia Intensiva, Fundación Clínica Médica Sur, Mexico, D.F., Mexico.
Cir Cir. 2009 Jul-Aug;77(4):301-8; 279-85.
Consistent data about sepsis in Mexico are lacking. The objective of this epidemiological study is to better define the incidence, characteristics and outcome of sepsis in Mexican intensive care units (ICUs).
This is a multicenter, transverse study performed in both private and public ICUs. Demographic data, comorbid diseases and clinical and laboratory data were collected prospectively.
A total of 135 ICUs from 24 states of Mexico were studied. From 40,957 annual hospitalizations 11,183 were due to sepsis, which represented 27.3% of admissions to ICU. From 11,183 patients with sepsis, 3402 died, representing a mortality rate of 30.4%. The most frequent sepsis trigger was abdominal infection (47%) followed by pulmonary infection (33%), soft tissue infection (8%) and kidney infection (7%); 5% were from other sources (neurological, osteoarticular). From the isolated bacteria, 52% were gram negative, 38% gram positive and 10% fungal infection; 60% of the private hospital ICUs and 40% of public hospital ICUs applied the Surviving Sepsis Campaign (p<0.05). In 50% of each of the ICUs, they adhere to the campaign recommendations. Costs in septic patients are high.
This study documents the high incidence of sepsis in Mexican ICUs, with high mortality rate and low adherence to Surviving Sepsis Campaign. Our data suggest that sepsis is a public health problem in Mexico.
墨西哥缺乏关于脓毒症的一致数据。这项流行病学研究的目的是更好地界定墨西哥重症监护病房(ICU)中脓毒症的发病率、特征及转归。
这是一项在私立和公立ICU中开展的多中心横断面研究。前瞻性收集人口统计学数据、合并症以及临床和实验室数据。
对来自墨西哥24个州的135个ICU进行了研究。在每年40957例住院病例中,11183例是由脓毒症所致,占ICU入院病例的27.3%。在11183例脓毒症患者中,3402例死亡,死亡率为30.4%。最常见的脓毒症诱发因素是腹部感染(47%),其次是肺部感染(33%)、软组织感染(8%)和肾脏感染(7%);5%来自其他来源(神经、骨关节)。在分离出的细菌中,52%为革兰阴性菌,38%为革兰阳性菌,10%为真菌感染;60%的私立医院ICU和40%的公立医院ICU实施了《拯救脓毒症运动》(p<0.05)。在各ICU中,有50%遵循了该运动的建议。脓毒症患者的费用很高。
本研究证明墨西哥ICU中脓毒症的发病率很高,死亡率高且对《拯救脓毒症运动》的遵循率低。我们的数据表明脓毒症在墨西哥是一个公共卫生问题。