分析影响中国遵守《拯救脓毒症运动指南》3 小时和 6 小时达标率的结构指标：系统评价。

Analysis of structure indicators influencing 3-h and 6-h compliance with the surviving sepsis campaign guidelines in China: a systematic review.

机构信息

Department of Critical Care Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, 100730, China.

State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100000, China.

出版信息

Eur J Med Res. 2021 Mar 19;26(1):27. doi: 10.1186/s40001-021-00498-7.

DOI:10.1186/s40001-021-00498-7

PMID:33741043

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7976719/

Abstract

BACKGROUND

Compliance with the surviving sepsis campaign (SSC) guidelines (C) is a key factor affecting the effects of sepsis treatment. We designed this study to investigate the relationships of the structure indicators of ICU on 3 and 6-h C in China.

METHODS

A total of 1854 hospitals were enrolled in a survey, led by the China National Critical Care Quality Control Center (China-NCCQC) from January 1, 2018, through December 31, 2018. We investigated the 1854 hospitals' 3 and 6-h C, including compliance with each specific measure of the 3-h and 6-h SSC bundles. We also investigated the actual level of the structure indicators of ICU, released by China-NCCQC in 2015.The outcomes were in adherence with the SSC guidelines (2016). Monitoring indicators included 3 and 6-h C.

RESULTS

In the subgroup, the rate of broad-spectrum antibiotic therapy was the highest, and the rate of CVP and ScvO2 measurement was the lowest among the items of 3 and 6-h C. Structure indicators related to 3 and 6-h C include the predicted mortality rate and the standardized mortality ratio (SMR). The relationships between 3 and 6-h C and the proportion of ICU in total inpatient bed occupancy, the proportion of acute physiology and chronic health evaluation (APACHE) II score ≥ 15 in all ICU patients were uncertain. There was no relationship of 3 and 6-h C with the proportion of ICU patients among total inpatients.

CONCLUSIONS

Structure indicators influencing 3 and 6-h C in China are the predicted mortality rate and the standardized mortality rate.

摘要

背景

遵守存活脓毒症运动（SSC）指南（C）是影响脓毒症治疗效果的关键因素。我们设计了这项研究，以调查中国 ICU 结构指标与 3 小时和 6 小时 C 的关系。

方法

2018 年 1 月 1 日至 12 月 31 日，由中国国家重症医学质量控制中心（China-NCCQC）领导，对 1854 家医院进行了一项调查。我们调查了这 1854 家医院的 3 小时和 6 小时 C，包括对 SSC 包的 3 小时和 6 小时的每一项具体措施的遵守情况。我们还调查了 China-NCCQC 于 2015 年发布的 ICU 结构指标的实际水平。结果符合 SSC 指南（2016 年）。监测指标包括 3 小时和 6 小时 C。

结果

在亚组中，广谱抗生素治疗的比例最高，而 CVP 和 ScvO2 测量的比例在 3 小时和 6 小时 C 的项目中最低。与 3 小时和 6 小时 C 相关的结构指标包括预测死亡率和标准化死亡率（SMR）。3 小时和 6 小时 C 与 ICU 在总住院床位占用中的比例、所有 ICU 患者中急性生理学和慢性健康评估（APACHE）II 评分≥15 的比例之间的关系不确定。3 小时和 6 小时 C 与 ICU 患者在总住院患者中的比例之间没有关系。