Epidemiological Study Of Systemic Infection

Introduction:Information about sepsis based on population in mainland China remains scarce and incomplete. The purpose of this study was to describe the epidemiology and outcome of sepsis in Yuetan Subdistrict of Beijing, and to calculate the population incidence of sepsis in Beijing and Mainland China.Methods:All adult patients living in Yuetan Subdistrict and having been admitted into public hospitals during the period of 1 July 2012 to 30 June 2013 were identified using database of Beijing Healthcare Insurance Information System, and all medical records were manually reviewed. Patients with sepsis were included in the analysis.Results:There were 9990 adult patients hospitalizedin 111 hospitals during the study period. A total of 9108 medical records were manually reviewed.There were 735 patients developing sepsis, including 245 patients with severe sepsis,and 108 patients with septic shock. The incidence of sepsis, severe sepsis and septic shock in Yuetan Subdistrict were 571,190 and 84 cases per 100000 population per year, respectively. Most infections were community-acquired, with pulmonary infection as the most common infection. Gram-negative organisms were the predominant pathogens. The overall hospital mortality rate was 20.1% for sepsis,49.0% for severe sepsis, and 80.6% for septic shock.Older age, ultimately or rapidly fatal disease, presence of severe sepsis and higher SOFA score at sepsis onset were independent risk factors for death in sepsis patients, while community-acquired infection was a protective factor.Conclusions:In a relatively elderly population with multiple comorbidities in mainland China, the incidence of sepsis with a poor prognosis in a relatively older and unhealthy population in Mainland China. The calculated population incidence rate in our study was higher than that in other countries, indicating that sepsis represents a major disease burden in mainland China. Prospective studies should be performed to accurately determine the national population incidence of sepsis as well as the outcome and associated costs of care.Introduction:Information about sepsis in mainland China remains scarce and incomplete. The purpose of this study was to describe the epidemiology and outcome of severe sepsis and septic shock in mixed ICU in mainland China, as well as the independent predictors of mortality.Methods::We performed a 2-month prospective, observational cohort study in 22 closed multi-disciplinary intensive care units (ICUs). All admissions into those ICUs during the study period were screened and patients with severe sepsis or septic shock were included.Results:A total of 484 patients,37.3 per 100 ICU admissions were diagnosed with severe sepsis (n=365) or septic shock (n=119) according to clinical criteria and included into this study. The most frequent sites of infection were the lung and abdomen. The overall ICU and hospital mortality rates were 28.7%(n=139) and 33.5%(n=162), respectively. In multivariate analyses, APACHE II score (odds ratio[OR],1.068; 95% confidential interval[CI],1.027-1.109), presence of ARDS (OR,2.676; 95%CI,1.691-4.235), bloodstream infection (OR,2.520; 95%CI,1.142-5.564) and comorbidity of cancer (OR, 2.246; 95%CI,1.141-4.420) were significantly associated with mortality.Conclusions:Our results indicated that severe sepsis and septic shock were common complications in ICU patients and with high mortality in China, and can be of help to know more about severe sepsis and septic shock in China and to improve characterization and risk stratification in these patients.