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2009年至2018年香港人口败血症发病率,死亡率和趋势使用临床和行政数据
Lowell Ling1, Jack Zhenhe Zhang1, Lok Ching Chang1
1Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
概括
基于电子健康记录 (EHR) 的败血症监测准确地发现了比行政数据更多的病例. 这种方法显示,香港的败血症发病率和死亡率增加,突出了其对人口健康监测的优势.
科学领域:
- 公共卫生监督 公共卫生监督
- 流行病学 流行病学
- 医疗信息学 医疗信息学
背景情况:
- 基于电子健康记录 (EHR) 的数据提供了与行政数据相比更准确的败血症监测的潜力.
- 在使用EHR数据来估计人口层面的败血症负担方面的经验有限.
研究的目的:
- 评估基于EHR的毒监测定义的准确性和可行性.
- 为了估计在香港的人口层面的败血症发病率,死亡率和病例死亡率风险 (CFR) 趋势.
主要方法:
- 香港成人住院病人的回顾性队列研究 (2009-2018).
- 由临床感染证据和器官功能障碍定义的败血症 (SOFA评分增加≥2分).
- 通过500次医疗记录审查,与四个行政定义相比,EHR定义的性能得到了比较.
主要成果:
- 在1350万例医院发作中,3.6%满足了基于EHR的败血症标准,CFR为22.4%.
- 标准化败血症发病率每年增加2.8%,死亡率每年增加1.9% (2009-2018).
- 在准确性方面,EHR定义 (AUC: .91) 显著超过行政定义 (AUC: .52-.55).
结论:
- 基于EHR的客观监测定义准确地确定了香港人口水平血症发病率和死亡率的增加.
- 基于EHR的方法表现出与败血症监测的行政定义相比具有显著的优势.
- 研究结果支持基于电子健康记录的方法对广泛的败血症监测的可行性和实用性.
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