Assessing available information on the burden of sepsis: global estimates of incidence, prevalence and mortality.
Assessing available information on the burden of sepsis: global estimates of incidence, prevalence and mortality.
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DOI：
10.7189/jogh.02.010404
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发表时间：
2012-06
影响因子：
7.2
通讯作者：
Rafnsson SB
中科院分区：
文献类型：
--
作者：
Jawad I;Lukšić I;Rafnsson SB
脓毒症是一种复杂且难以定义的疾病，与其他疾病有许多不同的相互作用。目前，没有全球一级脓毒症和败血症负担的估计数，也没有纳入最初的全球疾病负担研究。非孕产妇败血症最近才作为一个重大的全球公共卫生问题受到关注。本研究的目的是评估社区中非孕产妇脓毒症、严重脓毒症和脓毒性休克负担的现有数据，并确定估计全球脓毒症负担所需信息的关键差距。报告脓毒症、严重脓毒症和脓毒性休克的发病率、患病率、死亡率或病死率的英语研究的文献综述。使用1980年至2008年间发表的生物医学研究文章的引文和摘要MEDLINE数据库检索可用文献。8项研究报告了全国范围内脓毒症、严重脓毒症或脓毒性休克的发生率（4项来自美国，1项来自巴西、英国、挪威和澳大利亚）。脓毒症在发展中国家的发病率、患病率、死亡率和病死率未见相关研究，脓毒症的人群发病率为22 ~ 240/10万（最合理的估计数为149/100 000至240/100 000）;严重脓毒症从13/100 000到300/100 000（大多数估计值在56/100 000到91/100 000之间）;脓毒性休克为11/100 000。病死率取决于疾病的环境和严重程度。对于脓毒症，它可以达到30%，对于严重脓毒症，它可以达到50%，对于脓毒性休克，它可以达到80%。虽然数据是按照严格的纳入和排除标准汇编的，但报告的估计数仍存在一定程度的不确定性。现有的少数国家一级的报告只能对发达国家脓毒症的发病率进行非常粗略的估计，而发展中国家的数据显然缺乏。迫切需要通过在发展中国家开展研究，对脓毒症作出明确和普遍的定义，并制定一个健全的流行病学框架，以便开始解决这一问题的严重性。
Sepsis is a complex and hard-to-define condition with many different interactions with other disorders. Presently, there are no estimates of the burden of sepsis and septicaemia at the global level and it was not included in the initial Global Burden of Disease study. Non-maternal sepsis has only recently received attention as a substantial global public health problem. The aim of this study was to assess available data on the burden of non-maternal sepsis, severe sepsis and septic shock in the community and to identify key gaps in information needed to estimate the global burden of sepsis. Literature review of English language-based studies reporting on the incidence, prevalence, mortality or case-fatality of sepsis, severe sepsis and septic shock. The available literature was searched using the MEDLINE database of citations and abstracts of biomedical research articles published between 1980 and 2008. 8 studies reported incidence of sepsis, severe sepsis or septic shock at the national level (4 from the USA and 1 from Brazil, the UK, Norway and Australia). No studies on the incidence, prevalence, mortality or case-fatality from sepsis in developing countries were found. The population sepsis incidence ranged from 22 to 240/100 000 (most plausible estimates ranged from 149 to 240/100 000); of severe sepsis from 13 to 300/100 000 (most of the estimates were between 56 and 91/100 000); and of septic shock 11/100 000. Case-fatality rate depends on the setting and severity of disease. It can reach up to 30% for sepsis, 50% for severe sepsis and 80% for septic shock. While the data were compiled using strict inclusion and exclusion criteria, a degree of uncertainty still exists regarding the reported estimates. The few national-level reports available allow only a very crude estimation of the incidence of sepsis in developed countries while there is apparent lack of data from developing countries. A clear and universal definition of sepsis as well as the development of a sound epidemiological framework to begin addressing the magnitude of this problem is urgently needed through research in developing countries.