University of Texas Health Science Center, Houston, Texas, USA.
Shock. 2012 Jan;37(1):4-16. doi: 10.1097/SHK.0b013e318237d6bf.
The purpose of this systematic review of the literature was to determine the association of sepsis with mortality in the severely injured adult patient by means of a comparative analysis of sepsis in burn and trauma injury with other critically ill populations. The MEDLINE (PubMed), Cochrane Library, and ProQuest databases were searched. The following keywords and MeSH headings were used: "sepsis," septicemia," "septic shock," "epidemiology," "burns," "thermal injury," "trauma," "wounds and injuries," "critical care," "intensive care," "outcomes," and "mortality." Included studies were clinical studies of adult burn, trauma, and critically ill patients that reported survival data for sepsis. Thirty-eight articles were reviewed (9 burn, 11 trauma, 18 general critical care). The age of burn (<45 years) and trauma (34-49 years) groups was lower than the general critical care (57-64 years) population. Sepsis prevalence varied with trauma-injured patients experiencing fewer episodes (2.4%-16.9%) contrasted with burn patients (8%-42.5%) and critical care patients (19%-38%). Survival differed with trauma patients experiencing a lower rate of mortality associated with sepsis (7%-36.9%) compared with the burn (28%-65%) and critical care (21%-53%) groups. This study is the first to compare sepsis outcomes in three distinct patient populations: burn, trauma, and general critical care. Trauma patients tend to have relatively low sepsis-associated mortality; burn patients and the older critical care population have higher prevalence of sepsis with worse outcomes. Great variability of criteria to identify septic patients among studies compromises population comparisons.
本次文献系统回顾的目的是通过对烧伤和创伤患者与其他危重病患者的脓毒症进行比较分析，确定脓毒症与成年严重创伤患者死亡率之间的关系。检索了 MEDLINE（PubMed）、Cochrane 图书馆和 ProQuest 数据库。使用了以下关键词和 MeSH 标题：“脓毒症”、“败血症”、“感染性休克”、“流行病学”、“烧伤”、“热损伤”、“创伤”、“伤口和损伤”、“重症监护”、“强化护理”、“结果”和“死亡率”。纳入的研究是对成年烧伤、创伤和危重病患者进行的临床研究，报告了脓毒症的生存数据。共回顾了 38 篇文章（9 篇烧伤、11 篇创伤、18 篇一般重症监护）。烧伤（<45 岁）和创伤（34-49 岁）组的年龄低于一般重症监护（57-64 岁）人群。脓毒症的患病率因创伤患者发生的病例较少（2.4%-16.9%）而有所不同，而烧伤患者（8%-42.5%）和重症监护患者（19%-38%）则较多。由于创伤患者发生脓毒症相关死亡率较低（7%-36.9%），与烧伤（28%-65%）和重症监护（21%-53%）患者的存活率不同。本研究首次比较了三个不同患者群体的脓毒症结局：烧伤、创伤和一般重症监护。创伤患者的脓毒症相关死亡率相对较低；烧伤患者和年龄较大的重症监护人群的脓毒症患病率较高，预后较差。研究中确定脓毒症患者的标准存在很大差异，影响了人群比较。
