严重脓毒症的流行病学：2008 - 2012年

Epidemiology of severe sepsis: 2008-2012.

作者信息

Stoller Jeremy, Halpin Laura, Weis Matthew, Aplin Brett, Qu Weikai, Georgescu Claudiu, Nazzal Munier

机构信息

Department of Surgery, University of Toledo Medical Center, Toledo, OH.

出版信息

J Crit Care. 2016 Feb;31(1):58-62. doi: 10.1016/j.jcrc.2015.09.034. Epub 2015 Oct 24.

DOI:10.1016/j.jcrc.2015.09.034

PMID:26601855

Abstract

INTRODUCTION

Severe sepsis continues to be a significant burden on society.

METHODS

Using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, we analyzed the Healthcare Cost and Utilization Project National Inpatient Sample in order to estimate epidemiologic trends of severe sepsis from the years 2008 to 2012. The 2010 US Census, which included 308,745,538 individuals, was used to calculate incidence per 100,000 persons.

RESULTS

There were a total of 6,067,789 discharges for severe sepsis. The annual incidence increased from 346/100,000 to 436/100,000 persons (P < .05). Individuals with 3 or greater organ system failures increased from 31.6% to 35.5% (P < .05), and they accounted for 57.2% to 66.7% of the total number of deaths. Overall mortality decreased from 22.2% to 17.3% (P < .05). Length of stay decreased from 9 to 7 days (P < .05). Those discharged to home with and without home-health increased (23%-27%; P < .05), but those discharged to skilled nursing facilities remained the same (35%).

CONCLUSIONS

The incidence of severe sepsis continues to increase, whereas mortality decreases. However, one third of patients (those with ≥3 organ system failures) account for two thirds of the total number of deaths. More people are discharged home, whereas stable numbers go to facilities.

摘要

引言

严重脓毒症仍然是社会的一项重大负担。

方法

我们使用国际疾病分类第九版临床修订本编码，分析了医疗成本与利用项目国家住院病人样本，以估计2008年至2012年严重脓毒症的流行病学趋势。采用包含308,745,538人的2010年美国人口普查数据来计算每10万人中的发病率。

结果

严重脓毒症出院病例总数为6,067,789例。年发病率从每10万人346例增至436例（P < 0.05）。伴有3个或更多器官系统功能衰竭的患者比例从31.6%增至35.5%（P < 0.05），且占死亡总数的57.2%至66.7%。总体死亡率从22.2%降至17.3%（P < 0.05）。住院时间从9天降至7天（P < 0.05）。接受或未接受家庭保健服务而出院回家的患者人数增加（23% - 27%；P < 0.05），但出院至专业护理机构的患者人数保持不变（35%）。