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感染率と急性臓器機能不全のリスクが,重度のセプシスにおける人種差異の説明である
Florian B Mayr1, Sachin Yende, Walter T Linde-Zwirble
1CRISMA Laboratory, Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA 15261, USA.
JAMA
|June 24, 2010
まとめ
重度のセプシスの人種差異は,感染率の上昇と黒人の臓器機能不全のリスクの増加の両方によって引き起こされます. これらの要因は,黒人集団における重症性セプシスの発生率と死亡率の上昇に寄与しています.
科学分野:
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
- 健康の格差について
背景:
- 感染症と臓器機能障害によって特徴づけられる重度のセプシスは,黒人の個人に不均衡に影響を及ぼし,白人個人に比べて高い死亡率につながります.
- 深刻なセプシスの発生率と結果におけるこれらの人種差の根本的な原因は,まだ完全に理解されていません.
研究 の 目的:
- 黒人患者の重症性セプシスの発生率が高くなるのは,感染の発生率が高いか,急性臓器機能不全に対する感受性の高まりによるものであるかどうかを調査する.
- 感染率と臓器機能不全のリスクが重症性セプシスにおける人種差異に与える影響を定量化する.
主な方法:
- 感染関連入院 (2005年) や緊急診療所訪問 (2003年~2007年) を含む,人口ベースの大規模なデータセットの分析を,7つのアメリカ州で行いました.
- 重度のセプシスおよび感染症入院の年齢および性別標準化率の計算.
- 黒人対白人患者における急性臓器機能障害の発症リスクの評価,人口統計学的および臨床的要因を調整.
主要な成果:
- 黒人の患者は,年齢と性別で標準化された重症性セプシスの割合が67%高く,白人の患者と比較して死亡率が80%高い.
- 重度のセプシスの格差は,黒人の感染率 (39%増加) と急性臓器機能不全のリスク (29%増加) が高く,黒人の感染率が高く,黒人の臓器機能不全のリスクが高く,黒人の感染率が高く,黒人の臓器機能不全のリスクが高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高く,黒人の臓器機能不全が高くなった.
- これらの差異は,さまざまな感染タイプと環境で観察され,格差は若い成人の間で最も顕著でした.
結論:
- 深刻なセプシスの発生率と死亡率における人種差異は,感染感受性の増加と黒人の臓器機能不全へのより高い傾向の両方から生じる多因性である.
- これらの格差に対処するには,感染率を低減し,黒人人口の臓器機能不全のリスクを軽減するために,ターゲットを絞った介入が必要です.
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