Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.
F-CRIN INI-CRCT Network, Nancy, France.
Curr Opin Anaesthesiol. 2021 Apr 1;34(2):71-76. doi: 10.1097/ACO.0000000000000958.
The epidemiology of sepsis and septic shock has been challenging to study for multiple reasons. These include changing diagnostic definitions, as well a high concentration of sepsis-related studies published from high-income countries (HICs), despite a large global burden. This section attempts to address the incidence of sepsis throughout the years and worldwide.
The incidence of sepsis and septic shock has continued to increase since the first consensus definitions (Sepsis-1) were established in 1991, and the latest definitions (Sepsis-3) provide a better reflection of mortality risk for a diagnosis of sepsis. Several studies argue that the incidence of sepsis is overreported in HICs, based on billing and coding practices, and may lead to overutilization of resources. However, recent estimates of the true global burden of sepsis, including low-income countries, are likely much higher than reported, with calls for better allocation of resources.
The true epidemiology of sepsis worldwide continues to be a highly debated subject, and more research is needed among low-income countries and high-risk subpopulations.
由于多种原因,脓毒症和感染性休克的流行病学一直难以研究。这些原因包括不断变化的诊断定义,以及尽管全球负担沉重,但与脓毒症相关的研究主要集中在高收入国家(HICs)。本节试图阐明多年来全球脓毒症的发病率。
自 1991 年首次确定脓毒症 1 共识定义以来,脓毒症和感染性休克的发病率持续上升,最新的定义(Sepsis-3)更好地反映了脓毒症诊断的死亡率风险。一些研究认为,根据计费和编码实践,HICs 中脓毒症的发病率被高估了,这可能导致资源过度利用。然而,最近对包括低收入国家在内的全球脓毒症真实负担的估计可能远高于报告的水平,因此需要更好地分配资源。
全球脓毒症的真实流行病学仍然是一个备受争议的话题,低收入国家和高危亚人群需要进行更多的研究。