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比利时脓毒症国家行动计划(Be-SNAP)

Be-SNAP: the Belgian Sepsis National Action Plan.

作者信息

Mondelaers Annelies, Van de Voorde Febe, Peperstraete Harlinde, Dewitte Ken, De Waele Jan, Malfait Ilse, Van de Voorde Patrick, Vlieghe Erika

机构信息

Global Health Institute, University of Antwerp, Antwerp, Belgium.

Department of Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Antwerp, Belgium.

出版信息

Front Public Health. 2025 Jul 1;13:1575502. doi: 10.3389/fpubh.2025.1575502. eCollection 2025.


DOI:10.3389/fpubh.2025.1575502
PMID:40666145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12259572/
Abstract

Sepsis represents a significant healthcare challenge in Belgium with an estimated 40,952 cases annually (95% CI 31,938-54,451). This life-threatening condition leads to approximately 7,675 premature deaths per year (95% CI 6,421-9,089) and a loss of 38,106 quality-adjusted life years. The economic impact is substantial with annual costs ranging from €277 million to €4.3 billion. Despite this impact, Belgium lacks a national sepsis plan until present date. Following requests from diverse professional and patient organizations yielding public and political attention, the federal minister of Health requested a scientific advice to be written (November 2023-May 2024), as a basis for a national sepsis plan. This article describes Belgium's approach to developing a National Sepsis Action Plan, highlighting evidence-based and contextualized key recommendations aimed at reducing the sepsis burden by building on existing initiatives. A multidisciplinary working group was established, including representatives of healthcare workers and professional societies representing relevant disciplines in first, second and tertiary health care settings, home care and long-term care facilities. In addition, input was sought from public health actors and experts (e.g., surveillance, vaccination programs) and patient organizations. A Haddon matrix was made and seven key topics were specified: (1) awareness, (2) prevention, (3) early warning, (4) patient management, (5) post-sepsis rehabilitation, (6) advanced care planning and (7) surveillance and research. For each item, core group members were defined. Each group conducted literature reviews and developed recommendations tailored to the Belgian healthcare system, with consensus achieved during plenary sessions. The final document was externally reviewed by national and international experts. This is the first document addressing comprehensively sepsis prevention and care in Belgium, in its diverse presentations across the community and healthcare system. The next critical steps will involve the establishment of an implementation team and design of a detailed implementation plan.

摘要

脓毒症是比利时医疗保健领域面临的一项重大挑战,估计每年有40952例病例(95%置信区间为31938 - 54451)。这种危及生命的疾病每年导致约7675人过早死亡(95%置信区间为6421 - 9089),并损失38106个质量调整生命年。其经济影响巨大,年度成本从2.77亿欧元到43亿欧元不等。尽管有如此影响,但截至目前比利时仍缺乏国家脓毒症计划。在不同专业和患者组织提出请求并引起公众和政治关注后,联邦卫生部长要求撰写一份科学建议(2023年11月 - 2024年5月),作为国家脓毒症计划的基础。本文描述了比利时制定国家脓毒症行动计划的方法,强调了基于证据且因地制宜的关键建议,旨在通过借鉴现有举措减轻脓毒症负担。成立了一个多学科工作组,成员包括医护人员以及代表初级、二级和三级医疗保健机构、家庭护理和长期护理机构相关学科的专业协会代表。此外,还征求了公共卫生工作者和专家(如监测、疫苗接种计划)以及患者组织的意见。制作了一个哈顿矩阵,并确定了七个关键主题:(1)意识,(2)预防,(3)早期预警,(4)患者管理,(5)脓毒症后康复,(6)临终关怀规划,(7)监测与研究。为每个主题确定了核心小组成员。每个小组进行了文献综述,并制定了适合比利时医疗保健系统的建议,在全体会议上达成了共识。最终文件由国内和国际专家进行了外部评审。这是第一份全面阐述比利时脓毒症预防和护理的文件,涵盖了社区和医疗保健系统中脓毒症的各种表现形式。接下来的关键步骤将包括组建实施团队和设计详细的实施计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f0/12259572/5a05e1d9a763/fpubh-13-1575502-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f0/12259572/43cf6bc0fa64/fpubh-13-1575502-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f0/12259572/5a05e1d9a763/fpubh-13-1575502-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f0/12259572/43cf6bc0fa64/fpubh-13-1575502-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f0/12259572/5a05e1d9a763/fpubh-13-1575502-g002.jpg

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本文引用的文献

[1]
Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050.

Lancet. 2024-9-28

[2]
Admission avoidance hospital at home.

Cochrane Database Syst Rev. 2024-3-5

[3]
Societal costs of sepsis in the Netherlands.

Crit Care. 2024-1-22

[4]
International Consensus Criteria for Pediatric Sepsis and Septic Shock.

JAMA. 2024-2-27

[5]
Combining the Nurse Intuition Patient Deterioration Scale with the National Early Warning Score provides more Net Benefit in predicting serious adverse events: A prospective cohort study in medical, surgical, and geriatric wards.

Intensive Crit Care Nurs. 2024-8

[6]
The trajectory of very old critically ill patients.

Intensive Care Med. 2024-2

[7]
Improving survival after cardiac arrest in Europe: The synergetic effect of rescue chain strategies.

Resusc Plus. 2023-12-21

[8]
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Ann Intensive Care. 2024-1-10

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Impact of continuous and wireless monitoring of vital signs on clinical outcomes: a propensity-matched observational study of surgical ward patients.

Br J Anaesth. 2024-3

[10]
Most patients with an increased risk for sepsis-related morbidity or death do not recognize sepsis as a medical emergency: results of a survey study using case vignettes.

Crit Care. 2023-11-17

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