Abu-Humaidan Anas H A, Ahmad Fatima M, Al-Binni Maysaa' A, Bani Hani Amjad, Abu Abeeleh Mahmoud
Department of Pathology, Microbiology, and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
Department of Clinical Sciences, School of Science, The University of Jordan, Amman, Jordan.
Crit Care Res Pract. 2021 Dec 30;2021:2741271. doi: 10.1155/2021/2741271. eCollection 2021.
Sepsis is a global health issue that is commonly encountered in the intensive care unit (ICU) and is associated with high morbidity and mortality. Available data regarding sepsis in low- and middle-income countries (LMIC) is lacking compared to higher income countries, especially using updated sepsis definitions. The lack of recent data on sepsis in Jordan prompted us to investigate the burden of sepsis among Jordanian ICU patients. We conducted a prospective cohort study at Jordan University Hospital, a tertiary teaching hospital in the capital, Amman. All adult patients admitted to the adult ICUs between June 2020 and January 2021 were included in the study. Patients' clinical and demographic data, comorbidities, ICU length of stay (LOS), medical interventions, microbiological findings, and mortality rate were studied. Descriptive and inferential statistics were used to analyse data from patients with and without sepsis. We observed 194 ICU patients during the study period; 45 patients (23.3%) were diagnosed with sepsis using the Sepsis-3 criteria. Mortality rate and median ICU LOS in patients who had sepsis were significantly higher than those in other ICU patients (mortality rate, 57.8% vs. 6.0%, value < 0.001, resp., and LOS 7 days vs. 4 days, value < 0.001, resp.). Additionally, sepsis patients had a higher combined number of comorbidities (2.27 ± 1.51 vs. 1.27 ± 1.09, value < 0.001). The use of mechanical ventilation, endotracheal intubation, and blood transfusions were all significantly more common among sepsis patients. A causative organism was isolated in 68.4% of sepsis patients with a prevalence of Gram-negative bacteria in 77.1% of cases. While the occurrence of sepsis in the ICU in Jordan is comparable to other regions in the world, the mortality rate of sepsis patients in the ICU remains high. Further studies from LMIC are required to reveal the true burden of sepsis globally.
脓毒症是一个全球性的健康问题，在重症监护病房（ICU）中很常见，且与高发病率和死亡率相关。与高收入国家相比，低收入和中等收入国家（LMIC）缺乏关于脓毒症的现有数据，尤其是使用最新的脓毒症定义时。约旦缺乏近期关于脓毒症的数据，这促使我们调查约旦ICU患者中脓毒症的负担。我们在首都安曼的一家三级教学医院——约旦大学医院进行了一项前瞻性队列研究。2020年6月至2021年1月期间入住成人ICU的所有成年患者均纳入研究。研究了患者的临床和人口统计学数据、合并症、ICU住院时间（LOS）、医疗干预措施、微生物学检查结果以及死亡率。使用描述性和推断性统计分析脓毒症患者和非脓毒症患者的数据。在研究期间，我们观察了194名ICU患者；45名患者（23.3%）根据脓毒症-3标准被诊断为脓毒症。脓毒症患者中的死亡率和ICU住院时间中位数显著高于其他ICU患者（死亡率分别为57.8%对6.0%，P值<0.001；住院时间分别为7天对4天，P值<0.001）。此外，脓毒症患者的合并症总数更多（分别为2.27±1.51对1.27±1.09，P值<0.001）。脓毒症患者中机械通气、气管插管和输血的使用都显著更常见。68.4%的脓毒症患者分离出了致病病原体；77.1%的病例中革兰氏阴性菌占优势。虽然约旦ICU中脓毒症的发生率与世界其他地区相当，但ICU中脓毒症患者的死亡率仍然很高。低收入和中等收入国家需要进一步开展研究，以揭示全球脓毒症的真实负担。
