Fleischmann Carolin, Thomas-Rueddel Daniel O, Hartmann Michael, Hartog Christiane S, Welte Tobias, Heublein Steffen, Dennler Ulf, Reinhart Konrad
Department of Anesthesiology and Intensive Care Medicine and Integrated Research and Treatment Center for Sepsis Control and Care (CSCC), Jena University Hospital, Pharmacy and Integrated Research and Treatment Center for Sepsis Control and Care (CSCC), Jena University Hospital, Department of Respiratory Medicine, Hannover Medical School and German Center for Lung Research, Department for Medical Controlling, Jena University Hospital.
Dtsch Arztebl Int. 2016 Mar 11;113(10):159-66. doi: 10.3238/arztebl.2016.0159.
Sepsis, the most severe manifestation of acute infection, poses a major challenge to health care systems around the world. To date, adequate data on the incidence and mortality of sepsis in Germany have been lacking.
Nationwide case-related hospital DRG statistics for the years 2007-2013 were used to determine the in-hospital incidence and mortality of sepsis. Cases were identified on the basis of the clinical and pathogen-based ICD-10 codes for sepsis. The statistical evaluation was standardized for age and sex and carried out separately for each age group.
The number of cases of sepsis rose by an average of 5.7% per year, from 200 535 in 2007 to 279 530 in 2013, corresponding to an increase in the adjusted in-hospital incidence from 256 to 335 cases per 100 000 persons per year. The percentage of patients with severe sepsis rose from 27% to 41%. The in-hospital mortality of sepsis fell over the same period by 2.7%, to 24.3%. In 2013, 67 849 persons died of sepsis in German hospitals (or died of another disease, but also had sepsis). The incidence was highest in the youngest and oldest age groups, and the in-hospital mortality rose nearly linearly with age from age 40 onward.
Sepsis and death from sepsis are markedly more common in Germany than previously assumed, and they are on the rise. Sepsis statistics should become a standard component of federal statistical reports on public health, as well as of hospital statistics. Preventive measures and evidencebased treatment should be implemented across the nation.
脓毒症是急性感染最严重的表现形式，给全球医疗保健系统带来了重大挑战。迄今为止，德国缺乏关于脓毒症发病率和死亡率的充分数据。
利用2007 - 2013年全国与病例相关的医院诊断相关分组（DRG）统计数据来确定脓毒症的院内发病率和死亡率。根据脓毒症基于临床和病原体的国际疾病分类第10版（ICD - 10）编码来识别病例。统计评估按年龄和性别进行标准化，并针对每个年龄组分别进行。
脓毒症病例数平均每年增加5.7%，从2007年的200535例增至2013年的279530例，相应地，调整后的院内发病率从每年每10万人256例增至335例。严重脓毒症患者的比例从27%升至41%。同期脓毒症的院内死亡率下降了2.7%，降至24.3%。2013年，德国医院有67849人死于脓毒症（或死于其他疾病，但同时患有脓毒症）。发病率在最年轻和最年长年龄组中最高，院内死亡率从40岁起随年龄几乎呈线性上升。
在德国，脓毒症及脓毒症导致的死亡比之前设想的明显更为常见，且呈上升趋势。脓毒症统计数据应成为联邦公共卫生统计报告以及医院统计的标准组成部分。应在全国范围内实施预防措施和循证治疗。
