败血症和所有原因和特定原因过早死亡之间的关联:一个前性队列研究
Wenhui Kang1, Jiyong Zhong1, Fei Wang1
1Department of Emergency and Critical Care Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China.
Frontiers in public health
|December 1, 2025
概括
败血症显著增加了因所有原因导致过早死亡的风险,包括心血管,呼吸道和与癌症有关的疾病. 隐性和综合性败血症的风险更高,特别是在患有并发症和不健康生活方式的人群中.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染反应失调引起的.
- 了解与败血症亚型相关的长期死亡风险对于公共卫生战略至关重要.
- 以前的研究还没有完全阐明不同败血症分类对过早死亡率的影响.
研究的目的:
- 调查败血症,包括其亚型 (隐含的,明确的和组合的) 与所有原因和特定原因过早死亡之间的关联.
- 为了确定与不同败血症分类相关的特定死亡风险.
- 探索年龄,并发症和生活方式等因素如何改变这些风险.
主要方法:
- 一项基于人口的前性队列研究,利用来自371,558名参与者的英国生物库数据 (2006-2010).
- 使用国际疾病分类第10版 (ICD-10) 医院记录中的代码来确定败血症病例.
- 考克斯的比例风险模型被用来估计调整的风险比率 (aHR) 和95%的置信区间 (CI) 过早死亡.
主要成果:
- 在12.7%的参与者 (47,149人) 中诊断出败血症.
- 败血症与所有原因过早死亡风险增加2.36倍相关 (aHR为2.36,95%CI为2.26-2.46).
- 观察到心血管 (aHR 2.35),呼吸系统 (aHR 7.30),癌症 (aHR 1.76) 和与感染有关的 (aHR 9.75) 过早死亡的风险增加.
- 综合隐性-显性败血症显示出最高风险 (aHR 2.60),其次是隐性败血症单独 (aHR 2.05) 和显性败血症单独 (aHR 1.72).
- 老年人,有多种并发症的人,以及那些不健康的生活方式的人 (Pinteraction < 0.001) 的死亡风险增加更为明显.
结论:
- 败血症,特别是隐性和联合形式,与所有原因和特定原因过早死亡率的增加密切相关.
- 这项研究强调了毒症在急性阶段之后的长期健康负担.
- 针对老年人,并发病患者和不健康的生活方式的干预措施可能对减轻与败血症相关的死亡率至关重要.
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