まとめ
セプシスと全身性炎症反応症候群 (SIRS) の新たな定義が確立されたが,患者の特徴は不明のままである. 多くの重度のSIRS患者には感染がなく,アウトカムも様々で,一貫した定義と研究におけるより長いフォローアップが必要となる.
科学分野:
- クリティカルケア・メディシン
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
背景:
- セプシスと全身性炎症反応症候群 (SIRS) の新しい定義が確立されました.
- これらの新しい定義に適合する患者集団に関する理解は限られている.
研究 の 目的:
- 重度のセプシスとSIRSの流行病学と自然史を解明する.
- これらの患者コホート内の既知および未知を特定するために.
主な方法:
- 複数の臨床試験 (メチルプレドニゾロン,VA システミック・セプシス,HA-1A,E5) での患者の特徴の比較分析.
主要な成果:
- 深刻なSIRS患者の有意な割合 (少なくとも15%) は,文書化された感染がない.
- 感染した患者では,細菌血症,グラム陰性感染症,およびショックが普遍的ではなかった.
- 死亡率は14日と1ヶ月でそれぞれ26%と42%で,グラム陽性とグラム陰性毒症の死亡率は同様でした.
結論:
- 重度のSIRS患者では,グラム陰性感染症を想定することを避ける;グラム陰性毒症の研究から得られた結果を一般化する際には注意を払う.
- セプシスまたはSIRSに関する研究では,少なくとも1ヶ月の死亡率の追跡調査を組み込む必要があります.
- 標準化された定義は,効果的なクロス・スタディ比較に不可欠です.
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