Clinical epidemiology and outcomes of community acquired infection and sepsis among hospitalized patients in a resource limited setting in Northeast Thailand: A prospective observational study (Ubon-sepsis)
Clinical epidemiology and outcomes of community acquired infection and sepsis among hospitalized patients in a resource limited setting in Northeast Thailand: A prospective observational study (Ubon-sepsis)
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DOI：
10.1371/journal.pone.0204509
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发表时间：
2018-09-26
期刊：
影响因子：
3.7
通讯作者：
Limmathurotsakul, Direk
中科院分区：
文献类型：
--
作者：
Hantrakun, Viriya;Somayaji, Ranjani;Limmathurotsakul, Direk
感染和败血症是全世界死亡的主要原因，但在资源有限的环境中，人们对流行病学和结果的了解还不够深入。我们从 2013 年 3 月至 2017 年 2 月进行了一项为期四年的前瞻性观察研究，旨在检查泰国东北部乌汶府一家资源有限的三级护理医院因社区获得性感染入院的成年人的临床流行病学和结果。纳入入院24小时内出现感染并伴有感染全身表现的住院患者。如果受试者在入组时的改良序贯器官衰竭评估 (SOFA) 评分 >= 2，则被归类为脓毒症。本研究已在 ClinicalTrials.gov 注册，编号为 NCT02217592。总共分析了 4,989 名患者。在该队列中，2,659 名 (53%) 为男性，中位年龄为 57 岁（范围 18-101）。其中，1,173 名患者（24%）主要就诊于研究医院，3,524 名患者（71%）从省内 25 家地区医院或 8 家较小医院转院，292 名患者（6%）从其他省份 30 家医院之一转院。三千七百一十六 (74%) 名患者被归类为患有脓毒症。与无脓毒症的患者相比，脓毒症患者的年龄分布更大，合并症的患病率更高。脓毒症患者 28 天死亡率为 21% (765/3,716)，非脓毒症患者 28 天死亡率为 4% (54/1,273) (p
Infection and sepsis are leading causes of death worldwide but the epidemiology and outcomes are not well understood in resource-limited settings. We conducted a four-year prospective observational study from March 2013 to February 2017 to examine the clinical epidemiology and outcomes of adults admitted with community-acquired infection in a resource-limited tertiary-care hospital in Ubon Ratchathani province, Northeast Thailand. Hospitalized patients with infection and accompanying systemic manifestations of infection within 24 hours of admission were enrolled. Subjects were classified as having sepsis if they had a modified sequential organ failure assessment (SOFA) score >= 2 at enrollment. This study was registered with ClinicalTrials.gov, number NCT02217592. A total of 4,989 patients were analyzed. Of the cohort, 2,659 (53%) were male and the median age was 57 years (range 18-101). Of these, 1,173 (24%) patients presented primarily to the study hospital, 3,524 (71%) were transferred from 25 district hospitals or 8 smaller hospitals in the province, and 292 (6%) were transferred from one of 30 hospitals in other provinces. Three thousand seven hundred and sixteen (74%) patients were classified as having sepsis. Patients with sepsis had an older age distribution and a greater prevalence of comorbidities compared to patients without sepsis. Twenty eight-day mortality was 21% (765/3,716) in sepsis and 4% (54/1,273) in non-sepsis patients (p