Current epidemiology of septic shock - The CUB-Rea network
Current epidemiology of septic shock - The CUB-Rea network
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DOI：
10.1164/rccm.2201087
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发表时间：
2003-07-15
影响因子：
24.7
通讯作者：
Guidet, B
中科院分区：
文献类型：
--
作者：
Annane, D;Aegerter, P;Guidet, B
为了更新脓毒性休克的流行病学，我们分析了从1993年至2000年8年间从22家医院收集的康复医院（CUB-Rea）数据库中100,554例重症监护病房入院患者的临床、微生物学和结局变量。感染性休克的总频率为8.2 / 100（即8251次住院）。这一比例从1993年的7.0‰上升到2000年的9.7‰。感染部位和病原菌类型的分布分析显示肺部感染发生率（p = 0.001）和多重耐药菌相关脓毒性休克发生率（p = 0.001）增加。粗死亡率为60.1%，从1993年的62.1%下降到2000年的55.9% （p = 0.001）。与没有脓毒症的重症监护病房入院患者相比，感染性休克死亡的额外风险为25.7(95%可信区间，24.0-27.3)，匹配的死亡优势比为3.9（95%可信区间，3.5-4.3）。脓毒性休克的发生频率随着多重耐药菌株的增多而增加。其粗死亡率正在下降，但感染性休克患者的死亡风险仍高于非感染性重症患者。
To update the epidemiology of septic shock we analyzed clinical, microbiologic, and outcome variables from 100,554 intensive care unit admissions on the College des Utilisateurs de Bases de donnees en Reanimation (CUB-Rea) database, collected from 22 hospitals over a 8-year period, 1993 to 2000. The overall frequency of septic shock was 8.2 per 100 admissions (i.e., 8,251 stays). It increased from 7.0 (in 1993) to 9.7 per 100 admissions (in 2000). The distribution analysis of the sites of infection and of the types of pathogens showed an increase in the rate of pulmonary infection (p = 0.001) and of multiresistant bacteria-related septic shock (p = 0.001). The crude mortality was 60.1% and declined from 62.1% (in 1993) to 55.9 (in 2000) (p = 0.001). As compared with matched intensive care unit admissions without sepsis, the excess risk of death due to septic shock was 25.7 (95% confidence interval, 24.0-27.3) and the matched odds ratio of death was 3.9 (95% confidence interval, 3.5-4.3). The frequency of septic shock is increasing with more multiresistant strains. Its crude mortality rate is decreasing, but patients with septic shock still have a high excess risk of death than critically ill patients who are nonseptic.