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中国高原地区感染性休克的流行病学分析

Epidemiological analysis of septic shock in the plateau region of China.

作者信息

Li Qianwei, Chai Wenzhao, Wang Xiaoting, Cheng Li, Cai Xin, Fu Jianlei, Pan Wenjun, Lin Guoying

机构信息

Department of Critical Care Medicine, Tibet Autonomous Region People's Hospital, Lhasa, China.

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

出版信息

Front Med (Lausanne). 2022 Sep 14;9:968133. doi: 10.3389/fmed.2022.968133. eCollection 2022.

Abstract

PURPOSE

Little epidemiological data exist on patients with severe infection in the plateau region of China, and the data that do exist are lacking in quality. Using the medical records of patients with severe infection in the Department of Intensive Medicine (intensive care unit; ICU) of the People's Hospital of Tibet Autonomous Region, this study analyzed the epidemiological and clinical characteristics of patients with septic shock in plateau area (Tibet), with the ultimate aim of reducing the incidence and mortality from this condition.

METHODS

Clinical data on 137 patients with septic shock in the studied ICU from November 2017 to October 2019 were retrospectively analyzed using SPSS, Version 21.0.

RESULTS

Among the 137 patients with septic shock, there were 47 survivors and 90 in-hospital or post-discharge deaths. There were 91 male patients and 46 female patients. The incidence of septic shock was 11.3%, and mortality rate was 65.7%. Median age was 55 years old, median APACHE-II score on the day of admission was 17, median SOFA score was 11, and median number of organ injuries was one. APACHE-II score ( = 0.02), SOFA score ( < 0.001), and the number of organ injuries ( < 0.001) were higher among patients who died than among survivors. The infections were mainly pulmonary and abdominal, and the main pathogen was gram-negative bacteria.

CONCLUSION

The incidence and mortality of septic shock in ICU wards in Tibet are very high. The APACHE-II score, SOFA score, and the number of organ damage on the first day after diagnosis are independent risk factors for septic shock. To some extent, this study reflects the epidemiological characteristics of septic shock in the plateau region of China (≥ 3,650 m above sea level) and provides data that can support the prevention and treatment of sepsis in the future. More and deeper epidemiological studies of septic shock are necessary.

摘要

目的

中国高原地区严重感染患者的流行病学数据较少,且现有数据质量欠佳。本研究利用西藏自治区人民医院重症医学科(重症监护病房;ICU)严重感染患者的病历,分析高原地区(西藏)感染性休克患者的流行病学和临床特征,最终目标是降低该病的发病率和死亡率。

方法

使用SPSS 21.0软件对2017年11月至2019年10月在该研究ICU的137例感染性休克患者的临床资料进行回顾性分析。

结果

137例感染性休克患者中,47例存活,90例院内或出院后死亡。男性患者91例,女性患者46例。感染性休克发病率为11.3%,死亡率为65.7%。中位年龄为55岁,入院当天APACHE-II评分中位数为17,SOFA评分中位数为11,器官损伤数量中位数为1个。死亡患者的APACHE-II评分(P = 0.02)、SOFA评分(P < 0.001)和器官损伤数量(P < 0.001)均高于存活患者。感染主要为肺部和腹部感染,主要病原体为革兰氏阴性菌。

结论

西藏ICU病房感染性休克的发病率和死亡率非常高。诊断后第一天的APACHE-II评分、SOFA评分和器官损伤数量是感染性休克的独立危险因素。本研究在一定程度上反映了中国高原地区(海拔≥3650米)感染性休克的流行病学特征,为未来脓毒症的防治提供了数据支持。有必要开展更多更深入的感染性休克流行病学研究。

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