Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Wien Klin Wochenschr. 2013 Jun;125(11-12):302-8. doi: 10.1007/s00508-013-0351-1. Epub 2013 May 18.
Sepsis is one of the leading causes of death in intensive care units (ICUs) and has enormous relevance in health economics. There is growing evidence, however, that a significant percentage of patients with sepsis are not treated in an ICU. The aim of this study was to describe the epidemiology and short- and long-term mortality of sepsis according to patients' location on general wards or in an ICU over a period of a year. We retrospectively collected data on patients with sepsis admitted to the General Hospital of Vienna during a 12-month period. We used world health organization (WHO) ICD-10 classification as the selection criterion and analyzed demographic data, length of stay, and 28-day, hospital, and 3-year mortality on general wards and in the ICU. A total of 68,305 inpatient admission episodes between January 1 and December 31, 2007 were screened for sepsis. Using ICD-10 codes we identified 139 patients with sepsis, giving a cumulative hospital incidence of 2 cases/1,000 admissions; 32 % of these patients needed ICU treatment. The overall 28-day mortality rate was 29.5 %, increasing to 55.4 % 3 years after hospital discharge. On general wards the 28-day mortality rate was 12.6 %, increasing to 42.1 % 3 years after discharge; the respective rates for the ICU were 65.9 and 84.1 %. Sepsis is a disease of predominantly elderly patients. The majority of sepsis occurred on general wards and about 30 % in the ICU. Considerable number of patients with sepsis on general wards died after hospital discharge, thus the often used 28-day in-hospital mortality rate may fail to capture the true impact of sepsis on subsequent outcome.
脓毒症是重症监护病房（ICU）死亡的主要原因之一，在健康经济学中具有重要意义。然而，越来越多的证据表明，相当一部分脓毒症患者并未在 ICU 接受治疗。本研究旨在描述在一年期间根据患者在普通病房或 ICU 的位置，脓毒症的流行病学以及短期和长期死亡率。我们回顾性地收集了维也纳综合医院在 12 个月期间收治的脓毒症患者的数据。我们使用世界卫生组织（WHO）ICD-10 分类作为选择标准，并分析了普通病房和 ICU 的人口统计学数据、住院时间以及 28 天、医院和 3 年死亡率。在 2007 年 1 月 1 日至 12 月 31 日期间，对 68305 例住院患者进行了脓毒症筛查。使用 ICD-10 编码，我们确定了 139 名脓毒症患者，累积医院发病率为每 1000 例住院患者中有 2 例；其中 32%的患者需要 ICU 治疗。总的 28 天死亡率为 29.5%，出院 3 年后增加到 55.4%。在普通病房，28 天死亡率为 12.6%，出院 3 年后增加到 42.1%；ICU 的相应死亡率分别为 65.9%和 84.1%。脓毒症主要发生在老年患者中。大多数脓毒症发生在普通病房，约 30%发生在 ICU。相当数量的普通病房脓毒症患者在出院后死亡，因此，常用的 28 天院内死亡率可能无法捕捉到脓毒症对随后结果的真正影响。
