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The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study
Background: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774866/ https://www.ncbi.nlm.nih.gov/pubmed/33392219 http://dx.doi.org/10.3389/fmed.2020.593808 |
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author | Wang, Meiping Jiang, Li Zhu, Bo Li, Wen Du, Bin Kang, Yan Weng, Li Qin, Tiehe Ma, Xiaochun Zhu, Duming Wang, Yushan Zhan, Qingyuan Duan, Meili Li, Wenxiong Sun, Bing Cao, Xiangyuan Ai, Yuhang Li, Tong Zhu, Xi Jia, Jianguo Zhou, Jianxin He, Yan Xi, Xiuming |
author_facet | Wang, Meiping Jiang, Li Zhu, Bo Li, Wen Du, Bin Kang, Yan Weng, Li Qin, Tiehe Ma, Xiaochun Zhu, Duming Wang, Yushan Zhan, Qingyuan Duan, Meili Li, Wenxiong Sun, Bing Cao, Xiangyuan Ai, Yuhang Li, Tong Zhu, Xi Jia, Jianguo Zhou, Jianxin He, Yan Xi, Xiuming |
author_sort | Wang, Meiping |
collection | PubMed |
description | Background: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore the prevalence, characteristics, risk factors, treatment, and outcomes of sepsis in critically ill patients in tertiary hospitals in China. Methods: A multicenter prospective observational cohort study was performed with consecutively collected data from adults who stayed in any intensive care unit (ICU) for at least 24 h; data were collected from 1 January 2014 to 31 August 2015, and patients were followed until death or discharge from the hospital. Results: A total of 4,910 patients were enrolled in the study. Of these, 2,086 (42.5%) presented with sepsis or septic shock on admission to the ICU or within the first 48 h after admission to the ICU. ICU mortality was higher in patients with sepsis (13.1%) and septic shock (39.0%) and varied according to geographical region. Acinetobacter, Pseudomonas, and Staphylococcus infections were associated with increased ICU mortality. In addition, age, Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores, pre-existing cardiovascular diseases, malignant tumors, renal replacement therapy (RRT), and septic shock were independent risk factors for mortality in patients with sepsis. The prompt administration of antibiotics (OR 0.65, 95% CI 0.46–0.92) and 30 mL/kg of initial fluid resuscitation during the first 3 h (OR 0.43, 95% CI 0.30–0.63) improved the outcome in patients with septic shock. Conclusions: Sepsis was common and was associated with a high mortality rate in critically ill patients in tertiary hospitals in China. The prompt administration of antibiotics and 30 mL/kg fluid resuscitation decreased the risk of mortality. |
format | Online Article Text |
id | pubmed-7774866 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77748662021-01-01 The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study Wang, Meiping Jiang, Li Zhu, Bo Li, Wen Du, Bin Kang, Yan Weng, Li Qin, Tiehe Ma, Xiaochun Zhu, Duming Wang, Yushan Zhan, Qingyuan Duan, Meili Li, Wenxiong Sun, Bing Cao, Xiangyuan Ai, Yuhang Li, Tong Zhu, Xi Jia, Jianguo Zhou, Jianxin He, Yan Xi, Xiuming Front Med (Lausanne) Medicine Background: Sepsis is a main cause of morbidity and mortality in critically ill patients. The epidemiology of sepsis in high-income countries is well-known, but information on sepsis in middle- or low-income countries is still deficient, especially in China. The purpose of this study was to explore the prevalence, characteristics, risk factors, treatment, and outcomes of sepsis in critically ill patients in tertiary hospitals in China. Methods: A multicenter prospective observational cohort study was performed with consecutively collected data from adults who stayed in any intensive care unit (ICU) for at least 24 h; data were collected from 1 January 2014 to 31 August 2015, and patients were followed until death or discharge from the hospital. Results: A total of 4,910 patients were enrolled in the study. Of these, 2,086 (42.5%) presented with sepsis or septic shock on admission to the ICU or within the first 48 h after admission to the ICU. ICU mortality was higher in patients with sepsis (13.1%) and septic shock (39.0%) and varied according to geographical region. Acinetobacter, Pseudomonas, and Staphylococcus infections were associated with increased ICU mortality. In addition, age, Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores, pre-existing cardiovascular diseases, malignant tumors, renal replacement therapy (RRT), and septic shock were independent risk factors for mortality in patients with sepsis. The prompt administration of antibiotics (OR 0.65, 95% CI 0.46–0.92) and 30 mL/kg of initial fluid resuscitation during the first 3 h (OR 0.43, 95% CI 0.30–0.63) improved the outcome in patients with septic shock. Conclusions: Sepsis was common and was associated with a high mortality rate in critically ill patients in tertiary hospitals in China. The prompt administration of antibiotics and 30 mL/kg fluid resuscitation decreased the risk of mortality. Frontiers Media S.A. 2020-12-17 /pmc/articles/PMC7774866/ /pubmed/33392219 http://dx.doi.org/10.3389/fmed.2020.593808 Text en Copyright © 2020 Wang, Jiang, Zhu, Li, Du, Kang, Weng, Qin, Ma, Zhu, Wang, Zhan, Duan, Li, Sun, Cao, Ai, Li, Zhu, Jia, Zhou, He, Xi and China Critical Care Sepsis Trial (CCCST) workgroup. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Wang, Meiping Jiang, Li Zhu, Bo Li, Wen Du, Bin Kang, Yan Weng, Li Qin, Tiehe Ma, Xiaochun Zhu, Duming Wang, Yushan Zhan, Qingyuan Duan, Meili Li, Wenxiong Sun, Bing Cao, Xiangyuan Ai, Yuhang Li, Tong Zhu, Xi Jia, Jianguo Zhou, Jianxin He, Yan Xi, Xiuming The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title_full | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title_fullStr | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title_full_unstemmed | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title_short | The Prevalence, Risk Factors, and Outcomes of Sepsis in Critically Ill Patients in China: A Multicenter Prospective Cohort Study |
title_sort | prevalence, risk factors, and outcomes of sepsis in critically ill patients in china: a multicenter prospective cohort study |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774866/ https://www.ncbi.nlm.nih.gov/pubmed/33392219 http://dx.doi.org/10.3389/fmed.2020.593808 |
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