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使用行政数据和临床病历审查估计败血症发病率
Lisa Mellhammar1, Erik Wollter1, Jacob Dahlberg1
1Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden.
可靠的败血症流行病学数据至关重要. 将行政数据与临床审查联系起来,提高了准确性,揭示了败血症是瑞典重要的公共卫生问题.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
背景情况:
- 败血症对健康造成重大负担,但可靠的流行病学数据很少.
- 疾病与相关健康问题国际统计分类 (ICD) 编码的诊断对败血症的识别敏感性有限,无法评估病原体或抗菌素耐药性.
研究的目的:
- 通过将基于人口的行政数据与临床病历审查联系起来,增强败血症流行病学.
- 为了产生更准确的流行病学估计的败血症发病率,病例死亡率和抗菌素耐药性.
主要方法:
- 在瑞典斯堪尼亚地区 (2019-2020年) 进行了一项回顾性观察性队列研究.
- 败血症病例最初是使用行政数据库中的ICD代码来识别的.
- 对六层内的997次住院病例的临床病历进行了审查,以确定败血症诊断的参考标准 (败血症-3标准).
主要成果:
- 2019年,住院患者中的败血症发病率为4.1% (457/997),每年人口发病率为10万分之747人.
- 败血症患者的中位年龄为76岁,51%为女性,78%患有并发症.
- 与临床审查相比,ICD-10编码对败血症鉴定的有效性较低;在COVID-19大流行期间没有观察到败血症发病率的显著增加.
结论:
- 败血症在瑞典是一个相当大的公共卫生挑战.
- 将临床医疗记录数据与行政数据相结合,对于产生可靠的败血症流行病学至关重要.
- 提高数据准确性可以为公共卫生策略和用于败血症管理的资源配置提供信息.
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