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败血症患者中以前健康的成年人:人口层面的流行病学和结果
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, 701 W. 5(th) Street, Odessa, TX 79763, United States.
Journal of critical care
|September 17, 2023
概括
以前健康的成年人患有败血症的短期死亡率低于那些患有并发病的人. 这一发现适用于社区和医院发作的败血症病例,挑战了关于败血症患者结果的先前假设.
科学领域:
- 关键护理医学 关键护理医学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 最近的研究表明,以前健康的成年人与社区发作的败血症矛盾地表现出更高的短期死亡率.
- 这些发现对所有住院的败血症患者的概括性和适用性仍然不确定.
研究的目的:
- 在一大批住院的败血症患者中调查伴随疾病状态和短期死亡率之间的关联.
- 为了确定以前健康的成年人是否患有败血症,与伴随疾病的患者相比,死亡率有所不同.
主要方法:
- 利用全州德克萨斯州数据集 (2018-2019) 成人败血症住院情况 (N=120,371).
- 使用查尔森并发症指数和其他与死亡率相关的疾病定义的并发症.
- 采用等级模型来评估共患病状况与短期死亡率 (住院或临床治疗院出院) 之间的联系.
主要成果:
- 以前健康的成年人占败血症住院病例的5.5%.
- 在以前健康的个体中,短期死亡率显著降低 (11.7%),而与伴随疾病的个体 (28.2%) 相比.
- 这一趋势在社区发病 (11.0%与25.2%) 和医院发病的败血症 (22.0%与48.7%) 中持续存在,经过调整后的分析证实了以前健康人群的死亡率较低 (aOR 0.62).
结论:
- 以前健康的患有败血症住院的患者的短期死亡率明显降低.
- 这些发现挑战了先前的反直觉观察,并证实了先前健康的保护作用对败血症的结果.
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