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感染率和急性器官功能障碍风险是严重败血症种族差异的解释
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
概括
严重败血症的种族差异是由黑人个体感染率较高和器官功能障碍风险增加所驱动的. 这些因素导致黑人人口中严重败血症的发病率和死亡率较高.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 严重的败血症,以感染和器官功能障碍为特征,不成比例地影响黑人,导致与白人相比死亡率更高.
- 严重败血症发病率和结果的这些种族差异的根本原因仍然不完全理解.
研究的目的:
- 调查黑人患者严重败血症率的升高是否归因于感染的发病率较高或对急性器官功能障碍的易感性增加.
- 量化感染率和器官功能障碍风险对严重败血症种族差异的贡献.
主要方法:
- 基于人口的大规模数据集的分析,包括7个美国州的感染相关住院 (2005年) 和急诊室访问 (2003年至2007年).
- 严重败血症和感染住院病例的年龄和性别标准化率的计算.
- 评估黑人与白人患者发展急性器官功能障碍的风险,调整人口统计和临床因素.
主要成果:
- 与白人患者相比,黑人患者的严重败血症发病率高出67%的年龄和性别标准化,死亡率高出80%.
- 严重败血症的差异归因于黑人个体感染率较高 (39%的增加) 和急性器官功能障碍的风险较高 (29%的增加).
- 这些差异在各种感染类型和环境中观察到,差异在年轻人中最为明显.
结论:
- 严重败血症发病率和死亡率的种族差异是多因素的,源于黑人个体感染易感性增加和更高的器官功能障碍倾向.
- 解决这些差异需要有针对性的干预措施,以减少感染率和减轻黑人人口中器官功能障碍的风险.
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