Stenberg Henning, Li Xinjun, Pello-Esso Wazah, Larsson Lönn Sara, Thønnings Sara, Khoshnood Ardavan, Knudsen Jenny Dahl, Sundquist Kristina, Jansåker Filip
Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Sweden.
Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Denmark.
Prev Med Rep. 2023 Jul 16;35:102326. doi: 10.1016/j.pmedr.2023.102326. eCollection 2023 Oct.
Sepsis is a severe condition, representing a significant public health concern, especially in the elderly. There is, however, little insight into the potential effects of sociodemographic factors and comorbidities on sepsis incidence and how these factors interact. This was a nationwide open cohort study including individuals (N = 6 746 010) in Sweden ≥ 18 years of age spanning from 1997 to 2018, with 116 175 995 person years of follow-up. The outcome was time to first occurrence of sepsis. The following variables were included in the analysis: sociodemographic factors (age, sex, income, education, marital status, region of residency, and country of origin), severe mental disorders (schizophrenia and bipolar disorders), and Charlson Comorbidity Index. Interaction tests were conducted. A total of 161 558 individuals were diagnosed with sepsis during the study period, corresponding to an incidence rate of 13.9 per 10 000 person years (95% CI: 13.8 - 14.0). The main findings were that male sex, high age, low education, and comorbid conditions were positively associated with sepsis, after adjustments for the other covariates. Being aged 80 years and above yielded a HR of 18.19 (95% CI: 17.84 - 18.55) and the effect of high age was more than twice as high in men than in women. In conclusion, this large nationwide cohort found that several sociodemographic factors and comorbid conditions were independently associated with sepsis and men were more affected by higher age than women. These findings can help improve sepsis awareness and preventive work in risk groups.
脓毒症是一种严重病症，是一个重大的公共卫生问题，在老年人中尤为如此。然而，对于社会人口学因素和合并症对脓毒症发病率的潜在影响以及这些因素如何相互作用，人们了解甚少。这是一项全国性的开放性队列研究，纳入了1997年至2018年瑞典年龄≥18岁的个体（N = 6746010），随访人年数达116175995人年。研究结果是首次发生脓毒症的时间。分析中纳入了以下变量：社会人口学因素（年龄、性别、收入、教育程度、婚姻状况、居住地区和原籍国）、严重精神障碍（精神分裂症和双相情感障碍）以及查尔森合并症指数。进行了交互作用检验。在研究期间，共有161558人被诊断为脓毒症，发病率为每10000人年13.9例（95%置信区间：13.8 - 14.0）。主要研究结果是，在对其他协变量进行调整后，男性、高龄、低教育程度和合并症与脓毒症呈正相关。80岁及以上人群的风险比为18.19（95%置信区间：17.84 - 18.55），高龄对男性的影响是女性的两倍多。总之，这项大规模的全国性队列研究发现，多个社会人口学因素和合并症与脓毒症独立相关，且男性比女性更容易受到高龄的影响。这些研究结果有助于提高对脓毒症的认识以及在风险人群中开展预防工作。
