Sepsis-related mortality in China: a descriptive analysis
Sepsis-related mortality in China: a descriptive analysis
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DOI：
10.1007/s00134-018-5203-z
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发表时间：
2018-07-01
影响因子：
38.9
通讯作者：
Du, Bin
中科院分区：
文献类型：
--
作者：
Weng, Li;Zeng, Xin-ying;Du, Bin
在中国人群水平上描述和分析脓毒症相关死亡率是制定和评估干预策略的关键。回顾性分析中国基于人群的全国死亡监测系统（NMSS）中的多死因（MCOD）。我们的研究包括了中国605个疾病监测点（DSP）中发生的所有脓毒症相关死亡，覆盖了3.238亿人口。根据2010年和2015年的人口普查数据，分别估算了2010年和2015年的标准化死亡率和脓毒症相关死亡的全国估计值。2015年，605个DSP中共有1，937，299人死亡，标准化脓毒症相关死亡率为66.7（95%置信区间[CI] 66.4-67.0）每10万人死亡。全国估计有1，025，997人死于败血症。脓毒症相关死亡率表现出显著的地理差异。在多水平分析中，男性（率比[RR] 1.582，95% CI 1.570-1.595）、年龄增加（5年组RR 1.914，95% CI 1.910-1.917）和合并症的存在（RR 2.316，95% CI 2.298-2.335）与脓毒症相关死亡率增加独立相关。较高的可支配收入（第四个四分位数范围与第一个四分位数范围的RR 0.717，95%CI 0.515-0.978）和平均受教育年限（第四个四分位数范围与第一个四分位数范围的RR 0.808，95%CI 0.684-0.955）与脓毒症相关死亡率呈负相关。然而，基于人群的医院医生与脓毒症相关死亡率没有显著相关性。中国的标准化脓毒症相关死亡率很高，并且根据社会经济指标而变化，尽管仍存在一些不确定性。
A population-level description and analysis of sepsis-related mortality in China is key to the planning and assessment of interventional strategies.Retrospective analysis of multiple cause of death (MCOD) recorded in the population-based national mortality surveillance system (NMSS) of China. All sepsis-related deaths occurring in 605 disease surveillance points (DSPs) covering 323.8 million population across China were included in our study. Age-standardized mortality and national estimate of sepsis-related deaths were estimated using the census population in 2010 and 2015, respectively.In 2015, a total of 1,937,299 deaths occurring in any of the 605 DSPs and standardized sepsis-related mortality rate was 66.7 (95% confidence interval [CI] 66.4-67.0) deaths per 100,000 population. This produced a national estimate of 1,025,997 sepsis-related deaths. Sepsis-related mortality rates exhibited significant geographic variation. In multilevel analysis, male sex (rate ratio [RR] 1.582, 95% CI 1.570-1.595), increasing age (RR 1.914 for 5-year group, 95% CI 1.910-1.917), and presence of comorbidity (RR 2.316, 95% CI 2.298-2.335) were independently associated with increased sepsis-related mortality. Higher disposable income (RR 0.717 for the fourth interquartile range vs. the first interquartile range, 95% CI 0.515-0.978) and mean years of education (RR 0.808 for the fourth interquartile range vs. the first interquartile range, 95% CI 0.684-0.955) were negatively associated with sepsis-related mortality. However, population-based hospital doctors were not significantly associated with sepsis-related mortality.The standardized sepsis-related mortality rate in China was high and varied according to socioeconomic indices, even though some uncertainty remained.