Henriksen Daniel Pilsgaard, Laursen Christian B, Jensen Thøger Gorm, Hallas Jesper, Pedersen Court, Lassen Annmarie Touborg
1Department of Emergency Medicine, Odense University Hospital, Odense, Denmark. 2Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark. 3Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark. 4Department of Clinical Pharmacology, University of Southern Denmark, Odense, Denmark. 5Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
Crit Care Med. 2015 Jan;43(1):13-21. doi: 10.1097/CCM.0000000000000611.
Sepsis is a frequent cause of admission, but incidence rates based on administrative data have previously produced large differences in estimates. The aim of the study was to estimate the incidence of community-acquired sepsis based on patients' symptoms and clinical findings at arrival to the hospital.
Population-based survey.
Medical emergency department from September 1, 2010, to August 31, 2011.
All patients were manually reviewed using a structured protocol in order to identify the presence of infection. Vital signs and laboratory values were collected to define the presence of systemic inflammatory response syndrome and organ dysfunction.
Incidence rate of sepsis of any severity. Among 8,358 admissions to the medical emergency department, 1,713 patients presented with an incident admission of sepsis of any severity, median age 72 years (5-95%; range, 26-91 yr), 793 (46.3%) were men, 728 (42.5%) presented with a Charlson comorbidity index greater than 2,621 (36.3%) were admitted with sepsis, 1,071 (62.5%) with severe sepsis, and 21 (1.2%) with septic shock. Incidence rate was 731/100,000 person-years at risk (95% CI, 697-767) in patients with sepsis of any severity, 265/100,000 person-years at risk (95% CI, 245-287) in patients with sepsis, 457/100,000 person-years at risk (95% CI, 430-485) in patients with severe sepsis, and 9/100,000 person-years at risk (95% CI, 6-14) in patients with septic shock.
Based on symptoms and clinical findings at arrival, incidence rates of patients admitted to a medical emergency department with sepsis and severe sepsis are more frequent than previously reported based on discharge diagnoses.
脓毒症是住院的常见原因，但基于行政数据得出的发病率估计值此前差异很大。本研究的目的是根据患者入院时的症状和临床检查结果来估计社区获得性脓毒症的发病率。
基于人群的调查。
2010年9月1日至2011年8月31日的医疗急诊科。
所有患者均使用结构化方案进行人工检查，以确定是否存在感染。收集生命体征和实验室值以确定是否存在全身炎症反应综合征和器官功能障碍。
任何严重程度脓毒症的发病率。在8358例入住医疗急诊科的患者中，1713例患者因任何严重程度的脓毒症首次入院，中位年龄72岁（5-95%；范围，26-91岁），793例（46.3%）为男性，728例（42.5%）的查尔森合并症指数大于2，621例（36.3%）因脓毒症入院，1071例（62.5%）为严重脓毒症，21例（1.2%）为感染性休克。任何严重程度脓毒症患者的发病率为731/100,000人年（95%CI，697-767），脓毒症患者为265/100,000人年（95%CI，245-287），严重脓毒症患者为457/100,000人年（95%CI，430-485），感染性休克患者为9/100,000人年（95%CI，6-14）。
根据入院时的症状和临床检查结果，因脓毒症和严重脓毒症入住医疗急诊科患者的发病率比根据出院诊断报告的发病率更高。
