Ayala-Ramírez O H, Domínguez-Berjón M F, Esteban-Vasallo M D
Eur J Clin Microbiol Infect Dis. 2014 Mar;33(3):411-21. doi: 10.1007/s10096-013-1971-0.
The objectives of this investigation were to study the temporal trends in hospitalizations of patients with sepsis in the Region of Madrid (Spain) from 2003 to 2011 and analyze the factors associated with inpatient mortality. All sepsis hospitalizations from the minimum basic data set (MBDS) during 2003 to 2011 in the Region of Madrid were analyzed. Genderspecific crude and age-adjusted rates were calculated each year. Factors associated with death in these patients were studied with bivariate and multivariate analyses. Simultaneously, sepsis inpatients also underwent descriptive analysis. The study included 98,898 sepsis episodes. The incidence of sepsis hospitalizations per 100,000 habitants increased in males from 114.4 in 2003 to 262.2 in 2011, and in females from 91.2 to 209.1 between 2003 and 2011. The observed inpatient mortality was 23.2 %. There were 45,936 (46.4 %) episodes of severe sepsis (≥1 organ failure), revealing a clear upward trend, especially in multi-organ failure. Severe sepsis mortality showed a decreasing trend in both males (40.0 to 31.8 % from 2003 through 2011) and females (41.6 to 35.2 % from 2003 through 2011). Death was most frequent among the elderly and in patients with more organ failures and comorbidities. In a populous region of Southern Europe, an upward trend in sepsis incidence was observed between 2003 and 2011, as well as a decreasing trend in mortality for sepsis inpatients. Mortality increased with age, comorbidities, and organ failures.
本研究的目的是探讨2003年至2011年西班牙马德里地区脓毒症患者的住院时间趋势,并分析与住院死亡率相关的因素。对2003年至2011年马德里地区最低基本数据集(MBDS)中的所有脓毒症住院病例进行了分析。每年计算特定性别的粗发病率和年龄调整发病率。采用双变量和多变量分析研究这些患者死亡的相关因素。同时,对脓毒症住院患者也进行了描述性分析。该研究纳入了98,898例脓毒症发作病例。男性每10万居民中脓毒症住院发病率从2003年的114.4上升至2011年的262.2,女性从2003年的91.2上升至2011年的209.1。观察到的住院死亡率为23.2%。有45,936例(46.4%)严重脓毒症发作(≥1个器官衰竭),呈现出明显的上升趋势,尤其是在多器官衰竭方面。严重脓毒症死亡率在男性(从2003年至2011年从40.0%降至31.8%)和女性(从2003年至2011年从41.6%降至35.2%)中均呈下降趋势。死亡在老年人以及器官衰竭和合并症较多的患者中最为常见。在南欧一个人口众多的地区,2003年至2011年期间观察到脓毒症发病率呈上升趋势,同时脓毒症住院患者的死亡率呈下降趋势。死亡率随年龄、合并症和器官衰竭而增加。