Mușat Florentina, Păduraru Dan Nicolae, Bolocan Alexandra, Palcău Cosmin-Alexandru, Bunea Andrei-Alexandru, Ion Daniel, Andronic Octavian
Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania.
Department of Computer Science, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, Romania.
Medicina (Kaunas). 2025 May 8;61(5):864. doi: 10.3390/medicina61050864.
Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by reporting recent data from one of the largest emergency centers in Romania over an 18-year period (2007-2024). A retrospective analysis was conducted on 12,089 adult patients diagnosed with sepsis at the University Emergency Hospital of Bucharest. Patients were identified using International Classification of Diseases (ICD-10) codes and free-text diagnosis. Demographic and clinical data were extracted, including comorbidities, interventions, and mortality outcomes. Associations between comorbidities and in-hospital mortality were assessed using odds ratios (ORs) and 95% confidence intervals (CIs). The study population had a mean age of 68.7 years, with a slight predominance of males (50.9%). In-hospital mortality was 53.9%, and 30-day mortality reached 85.1%. The most common comorbidities were diabetes (27.2%), chronic kidney disease (14.0%), and cancer (12.9%). Pneumonia (OR = 2.08, 95% CI: 1.89-2.28), cirrhosis (OR = 1.69, 95% CI: 1.40-2.03), and chronic obstructive pulmonary disease (OR = 1.50, 95% CI: 1.27-1.77) were strong predictors of mortality, while diabetes was associated with a slightly lower risk (OR = 0.90, 95% CI: 0.83-0.97). Sepsis-related mortality in Romania is higher than reported in Western Europe and North America, resembling trends in resource-limited settings. Targeted early recognition, antimicrobial stewardship, and improved intensive care units (ICU) resource allocation are crucial for reducing mortality. Multicenter studies and microbiological analyses are needed to further understand sepsis outcomes in this region.
脓毒症是全球发病和死亡的主要原因，但中东欧的数据仍然匮乏。我们的研究旨在通过报告罗马尼亚最大的急诊中心之一在18年期间（2007 - 2024年）的最新数据，来解决脓毒症患者特征和死亡率信息稀缺的问题。对布加勒斯特大学急诊医院诊断为脓毒症的12089例成年患者进行了回顾性分析。使用国际疾病分类（ICD - 10）编码和自由文本诊断来识别患者。提取了人口统计学和临床数据，包括合并症、干预措施和死亡结局。使用比值比（OR）和95%置信区间（CI）评估合并症与住院死亡率之间的关联。研究人群的平均年龄为68.7岁，男性略占优势（50.9%）。住院死亡率为53.9%，30天死亡率达到85.1%。最常见的合并症是糖尿病（27.2%）、慢性肾病（14.0%）和癌症（12.9%）。肺炎（OR = 2.08，95% CI：1.89 - 2.28）、肝硬化（OR = 1.69，95% CI：1.40 - 2.03）和慢性阻塞性肺疾病（OR = 1.50，95% CI：1.27 - 1.77）是死亡率的强预测因素，而糖尿病与略低的风险相关（OR = 0.90，95% CI：0.83 - 0.97）。罗马尼亚脓毒症相关死亡率高于西欧和北美报道的水平，类似于资源有限地区的趋势。有针对性的早期识别、抗菌药物管理以及改善重症监护病房（ICU）资源分配对于降低死亡率至关重要。需要进行多中心研究和微生物分析，以进一步了解该地区的脓毒症结局。
