Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University, Jena, Germany -
Minerva Anestesiol. 2013 Sep;79(9):993-1002. Epub 2013 Jun 25.
Sepsis is an important cause of mortality and morbidity in the intensive care unit (ICU). We performed a study to describe the epidemiology of sepsis syndromes in patients admitted to ICUs of the Piedmont region.
In this prospective, multicentre, observational study, all 3902 patients admitted to a network of 24 ICUs from 17 hospitals during a 180 day period (April 3-September 29, 2006) were included. Patients were followed from the first day of admission until death or ICU discharge.
The incidence of sepsis during the ICU stay was 11.4% (N.=446), corresponding to an incidence of 25 cases/100,000 inhabitants/year; 141 (31.6%) patients had only sepsis, 160 patients had severe sepsis (35.9%) and 145 patients (32.5%) had septic shock In 227 patients (50.9%), sepsis was observed within 48 hours after admission to the ICU, and 219 patients (49.1%) developed ICU-acquired sepsis. The main sources of infection were the lungs, abdomen, and urinary tract. ICU mortality was higher (41.3 vs. 17.3%, P<0.0001) and the median ICU length of stay longer (15 vs. 2 days, P<0.0001) in patients with sepsis than in those without sepsis. The mortality rate increased with the severity of sepsis. ICU-acquired sepsis was associated with higher ICU mortality rates than sepsis occurring within 48 hours of ICU admission (49.8 vs. 33.0%, P<0.0001).
Sepsis is a common occurrence in critically ill patients. Our data underscore the regional variability in the epidemiology and outcome of sepsis syndromes and may be useful to guide appropriate resource allocation.
脓毒症是重症监护病房(ICU)中死亡和发病的重要原因。我们进行了一项研究,以描述皮埃蒙特地区 ICU 收治患者中脓毒症综合征的流行病学。
在这项前瞻性、多中心、观察性研究中,纳入了 2006 年 4 月 3 日至 9 月 29 日期间在 24 个 ICU 网络中的 17 家医院收治的所有 3902 名患者。患者从入院的第一天开始随访,直至死亡或 ICU 出院。
ICU 期间脓毒症的发生率为 11.4%(N=446),相当于每 100,000 居民/年发病 25 例;141 例(31.6%)患者仅有脓毒症,160 例患者患有严重脓毒症(35.9%),145 例患者(32.5%)患有脓毒性休克。在 227 例(50.9%)患者中,在入住 ICU 后 48 小时内观察到脓毒症,219 例(49.1%)患者发生 ICU 获得性脓毒症。感染的主要来源是肺部、腹部和泌尿道。患有脓毒症的患者 ICU 死亡率较高(41.3% vs. 17.3%,P<0.0001),ICU 住院时间中位数较长(15 天 vs. 2 天,P<0.0001)。脓毒症的严重程度与死亡率的增加有关。与入住 ICU 后 48 小时内发生的脓毒症相比,ICU 获得性脓毒症与更高的 ICU 死亡率相关(49.8% vs. 33.0%,P<0.0001)。
脓毒症在危重症患者中很常见。我们的数据强调了脓毒症综合征的流行病学和结局在区域上的差异,这可能有助于指导适当的资源分配。