Henriksen Daniel Pilsgaard, Pottegård Anton, Laursen Christian B, Jensen Thøger Gorm, Hallas Jesper, Pedersen Court, Lassen Annmarie Touborg
Department of Emergency Medicine, Odense University Hospital, DK-5000 Odense C, Denmark.
Clinical Pharmacology, Department of Public Health, University of Southern Denmark, DK-5000 Odense C, Denmark.
PLoS One. 2015 Apr 21;10(4):e0124838. doi: 10.1371/journal.pone.0124838. eCollection 2015.
The aim of the study was to estimate risk factors for hospitalization due to sepsis and to determine whether these risk factors vary by age and gender.
We performed a population-based case-control study of all adult patients admitted to a medical ED from September 2010 to August 2011. Controls were sampled within the hospital catchment-area. All potential cases were manually validated using a structured protocol. Vital signs and laboratory values measured at arrival were registered to define systemic inflammatory response syndrome and organ dysfunction. Multivariable logistic regression was used to elucidate which predefined risk factors were associated with an increased or decreased risk hospitalization due to sepsis.
A total of 1713 patients were admitted with sepsis of any severity. The median age was 72 years (interquartile range: 57-81 years) and 793 (46.3%) were male. 621 (36.3%) patients were admitted with sepsis, 1071 (62.5%) with severe sepsis and 21 (1.2%) with septic shock. Episodes with sepsis of any severity were associated with older age (85+ years adjusted OR 6.02 [95%CI: 5.09-7.12]), immunosuppression (4.41 [3.83-5.09]), alcoholism-related conditions (2.90 [2.41-3.50]), and certain comorbidities: psychotic disorder (1.90 [1.58-2.27]), neurological (1.98 [1.73-2.26]), respiratory (3.58 [3.16-4.06]), cardiovascular (1.62 [1.41-1.85]), diabetes (1.82 [1.57-2.12]), cancer (1.44 [1.22-1.68]), gastrointestinal (1.71 [1.44-2.05]) and renal (1.46 [1.13-1.89]). The strength of the observed associations for comorbid factors was strongest among younger individuals.
Hospitalization due to sepsis of any severity was associated with several independent risk factors, including age and comorbid factors.
本研究旨在评估脓毒症导致住院的风险因素，并确定这些风险因素是否因年龄和性别而异。
我们对2010年9月至2011年8月入住急诊科的所有成年患者进行了一项基于人群的病例对照研究。对照组在医院服务区域内抽样。所有潜在病例均使用结构化方案进行人工验证。记录入院时测量的生命体征和实验室值，以定义全身炎症反应综合征和器官功能障碍。采用多变量逻辑回归分析来阐明哪些预先定义的风险因素与脓毒症导致住院风险的增加或降低相关。
共有1713例患者因任何严重程度的脓毒症入院。中位年龄为72岁（四分位间距：57 - 81岁），793例（46.3%）为男性。621例（36.3%）患者因脓毒症入院，1071例（62.5%）因严重脓毒症入院，21例（1.2%）因感染性休克入院。任何严重程度的脓毒症发作均与高龄（85岁及以上校正比值比6.02 [95%置信区间：5.09 - 7.12]）、免疫抑制（4.41 [3.83 - 5.09]）、酒精相关疾病（2.90 [2.41 - 3.50]）以及某些合并症相关：精神障碍（1.90 [1.58 - 2.27]）、神经系统疾病（1.98 [1.7 – 2.26]）、呼吸系统疾病（3.58 [3.16 - 4.06]）、心血管疾病（1.62 [1.41 - 1.85]）、糖尿病（1.82 [1.57 - 2.12]）、癌症（1.44 [1.22 - 1.68]）、胃肠道疾病（1.71 [1.44 - 2.05]）和肾脏疾病（1.46 [1.13 - 1.89]）。观察到的合并症因素关联强度在较年轻个体中最强。
任何严重程度的脓毒症导致的住院与多个独立风险因素相关，包括年龄和合并症因素。
