Epidemiology of severe sepsis in intensive care units in the Slovak Republic
Epidemiology of severe sepsis in intensive care units in the Slovak Republic
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DOI：
10.1007/s15010-005-4019-2
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发表时间：
2005-06-01
期刊：
影响因子：
7.5
通讯作者：
Chlebo, P
中科院分区：
文献类型：
--
作者：
Z치horec, R;Firment, J;Chlebo, P
背景：我们调查了斯洛伐克重症监护室重症患者的数量、临床特征和结局，这些患者符合严重脓毒症的精确临床和生理标准（如英勇研究中定义的）。我们设计了一项观察性队列流行病学研究，对前瞻性收集的资料进行回顾性分析。2002年7月至12月期间，斯洛伐克共和国共有12个成人普通重症监护病房。患者和方法：纳入2002年下半年12个成人ICU收治的1533例患者。采用描述性统计方法（独立样本t检验、chi(2)检验和线性Pearson相关系数）。结果：重症监护病房中7.9%的住院危重患者符合严重脓毒症标准。最常见的原发感染源是肺部和腹部。严重脓毒症患者住院死亡率为51.2%（62例/121例）。大多数患者（85.1%）年龄在40岁至40岁之间。死亡率随年龄增长而增加；幸存者的平均年龄（53岁）显著低于非幸存者（61岁，p = 0.01）。与死亡率相关的因素是年龄超过50岁，三个或更多功能失调的器官，入院和最高SOFA评分升高。幸存者的器官系统功能障碍部位数量（MODS 2.56）明显低于非幸存者（MODS 3.98）。SOFA评分似乎是区分幸存者和非幸存者的有价值的工具。所有脓毒症患者SOFA评分均大于4分。严重脓毒症幸存者的入院和最高SOFA评分（中位数分别为8.7和9.4分）明显低于脓毒症非幸存者（中位数分别为11.6和14.0分，p = 0.001）。结论：我们估计每年有1770例严重败血症在斯洛伐克成人重症监护病房住院。严重脓毒症的住院死亡率仍然很高（51.2%），并与高龄（50岁以上）、器官衰竭数量、住院率和最高SOFA评分较高有关。
Background: We investigated the number, clinical characteristics, and outcomes of ICU patients, who met precise clinical and physiological criteria for severe sepsis (as defined in the PROWESS study) in Slovak intensive care units. We designed an observational cohort epidemiological study with retrospective analysis of prospectively collected data. 12 adult general intensive care units participated in the Slovak Republic between July and December 2002.Patients and Methods: Patients included 1,533 adult ICU admissions during the second half of 2002 in 12 adult ICUs. Descriptive statistical methods (independent sample T-test, chi(2) test, and Linear Pearson coefficient of correlation) were used.Results: We found that 7.9% of hospitalized critically ill patients met severe sepsis criteria in the intensive care units. The most frequent primary sources of infection were Lungs and abdomen. Hospital mortality of severe septic patients was 51.2% (62 pts/121 pts). Most patients (85.1%) were > 40 years of age. Mortality increased with age; mean average age of survivors (53 years) was significantly lower than in nonsurvivors (61 years, p = 0.01). Factors associated with mortality were age over 50 years, three or more dysfunctional organs, and elevated admission and maximum SOFA scores. Survivors had a significantly lower number of sites with organ system dysfunction (MODS 2.56) than nonsurvivors (MODS 3.98). SOFA score seems to be a valuable tool to differentiate survivors from nonsurvivors. ALL the septic patients had SOFA scores greater than 4 points. Survivors of severe sepsis were characterized with significantly Lower admission and maximum SOFA scores (median 8.7 and 9.4 points, respectively) than septic nonsurvivors (median 11.6 and 14.0 points, respectively, p = 0.001). Conclusion: We estimate 1,770 cases of severe sepsis hospitalized at Slovak adult intensive care units per year. Hospital mortality for severe sepsis remains very high (51.2%) and is associated with advanced age (over 50 years), number of failing organs and higher admission and maximum SOFA scores.