Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China.
Intensive Care Med. 2018 Jul;44(7):1071-1080. doi: 10.1007/s00134-018-5203-z. Epub 2018 May 30.
A population-level description and analysis of sepsis-related mortality in China is key to the planning and assessment of interventional strategies.
Retrospective analysis of multiple cause of death (MCOD) recorded in the population-based national mortality surveillance system (NMSS) of China. All sepsis-related deaths occurring in 605 disease surveillance points (DSPs) covering 323.8 million population across China were included in our study. Age-standardized mortality and national estimate of sepsis-related deaths were estimated using the census population in 2010 and 2015, respectively.
In 2015, a total of 1,937,299 deaths occurring in any of the 605 DSPs and standardized sepsis-related mortality rate was 66.7 (95% confidence interval [CI] 66.4-67.0) deaths per 100,000 population. This produced a national estimate of 1,025,997 sepsis-related deaths. Sepsis-related mortality rates exhibited significant geographic variation. In multilevel analysis, male sex (rate ratio [RR] 1.582, 95% CI 1.570-1.595), increasing age (RR 1.914 for 5-year group, 95% CI 1.910-1.917), and presence of comorbidity (RR 2.316, 95% CI 2.298-2.335) were independently associated with increased sepsis-related mortality. Higher disposable income (RR 0.717 for the fourth interquartile range vs. the first interquartile range, 95% CI 0.515-0.978) and mean years of education (RR 0.808 for the fourth interquartile range vs. the first interquartile range, 95% CI 0.684-0.955) were negatively associated with sepsis-related mortality. However, population-based hospital doctors were not significantly associated with sepsis-related mortality.
The standardized sepsis-related mortality rate in China was high and varied according to socioeconomic indices, even though some uncertainty remained.
对中国脓毒症相关死亡率进行人群水平描述和分析，这是规划和评估干预策略的关键。
对中国基于人群的国家死亡率监测系统（NMSS）中记录的多种死因（MCOD）进行回顾性分析。本研究纳入了中国 605 个疾病监测点（DSPs）中发生的所有与脓毒症相关的死亡病例，这些监测点覆盖了 3.238 亿人口。使用 2010 年和 2015 年的人口普查数据分别估计了年龄标准化死亡率和全国脓毒症相关死亡人数。
2015 年，605 个 DSP 中的任何一个 DSP 中发生的总死亡人数为 1937299 人，标准化脓毒症相关死亡率为 66.7（95%置信区间[CI] 66.4-67.0）/10 万人。这产生了全国估计有 1025997 例脓毒症相关死亡。脓毒症相关死亡率存在显著的地理差异。在多水平分析中，男性（比率比[RR] 1.582，95%CI 1.570-1.595）、年龄增长（5 岁组 RR 1.914，95%CI 1.910-1.917）和合并症存在（RR 2.316，95%CI 2.298-2.335）与脓毒症相关死亡率的增加独立相关。较高的可支配收入（第四四分位数与第一四分位数相比，RR 0.717，95%CI 0.515-0.978）和平均受教育年限（第四四分位数与第一四分位数相比，RR 0.808，95%CI 0.684-0.955）与脓毒症相关死亡率呈负相关。然而，基于人群的医院医生与脓毒症相关死亡率没有显著相关性。
中国的标准化脓毒症相关死亡率较高，且根据社会经济指标而有所不同，尽管仍存在一些不确定性。
