沙特阿拉伯16年来因脓毒症和脓毒性休克入住重症监护病房的患者结局

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-07-19 DOI:10.1016/j.jiph.2025.102911

Yaseen M. Arabi , Musharaf Sadat , Hasan M. Al-Dorzi , Hani Tamim , Saad AlQahtani , Haytham Tlajyeh , Farhan Zayed Alenezi , Tarek Dabbagh , Rasha Alanazi , Asma Alanazi , Nabiha Tashkandi , Wejdan Alrassasmah , Abdulaziz Al-Dawood

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引用次数: 0

摘要

背景：我们研究了16年来沙特阿拉伯一家三级医院重症监护病房（ICU）脓毒症和脓毒性休克患者的预后。方法采用前瞻性ICU数据库资料进行回顾性队列研究。我们纳入了2002年1月1日至2017年12月31日期间入院的所有脓毒症患者，脓毒症-3标准定义为脓毒症。主要终点是住院死亡率。此外，采用调整后的logistic回归模型来评估住院死亡率随时间的变化。结果在研究期间入住ICU的12645例患者中，5917例（46.8% %）符合脓毒症标准（年龄中位数= 65岁[四分位数范围：52,75]，急性生理和慢性健康评估评分II [APACHE II]中位数评分= 24[四分位数范围：19,31]，44.8% %为女性，32.3% %为脓毒症休克）。在脓毒症和感染性休克患者中，慢性合并症是常见的。2002年至2017年间，APACHE II评分和住院死亡率(脓毒症患者：粗优势比（OR）每1年增加0.95,95 %可信区间[CI] 0.94-0.97；APACHE ii调整OR 0.96, 95 % CI 0.95-0.98；感染性休克患者：粗OR 0.93, 95 % CI 0.91-0.95；APACHE ii调整后OR 0.96, 95 % CI 0.94-0.98)。2010-2017年期间，脓毒症患者的死亡率似乎有所下降（调整后的OR每1年增加0.88,95 % CI 0.85-0.91，而调整后的OR为0.99,95 % CI 0.96-1.04, 2002-2009年期间）。在脓毒性休克患者中也观察到类似的模式。结论脓毒症患者占ICU住院患者的近一半。在16年的研究期间，主要发生在2010年至2017年期间，脓毒症和脓毒性休克患者的住院死亡率随着时间的推移而下降。

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Outcomes of patients admitted to the intensive care unit with sepsis and septic shock in Saudi Arabia over 16 years

Background

We examined the outcomes of patients with sepsis and septic shock admitted to the intensive care unit (ICU) in a tertiary care hospital in Saudi Arabia over 16 years.

Methods

A retrospective cohort study was carried out using data collected prospectively in an ICU database. We included all patients admitted between January 1, 2002, and December 31, 2017, with sepsis defined by Sepsis-3 criteria. The primary outcome was hospital mortality. In addition, adjusted logistic regression models was used to evaluate the change in hospital mortality over time.

Results

Of 12,645 patients admitted to the ICU during the study period, 5917 patients (46.8 %) met the criteria for sepsis (median age= 65 years [interquartile range: 52, 75], median Acute Physiology And Chronic Health Evaluation Score II [APACHE II] score= 24 [interquartile range: 19, 31], 44.8 % were women and 32.3 % had septic shock). Among patients with sepsis and septic shock, chronic comorbidities were common. Between 2002 and 2017, there was a progressive decrease in APACHE II score and hospital mortality (among patients with sepsis: crude odds ratio (OR) for each 1-year increase 0.95, 95 % confidence interval [CI] 0.94–0.97; APACHE II-adjusted OR 0.96, 95 % CI 0.95–0.98; among patients with septic shock: crude OR 0.93, 95 % CI 0.91–0.95; APACHE II-adjusted OR 0.96, 95 % CI 0.94–0.98). The mortality reduction in patients with sepsis seems to have occurred in the 2010–2017 period (adjusted OR for each 1-year increase 0.88, 95 % CI 0.85–0.91 versus adjusted OR 0.99, 95 % CI 0.96–1.04 for the 2002–2009 period). A similar pattern was observed in patients with septic shock.

Conclusions

Patients with sepsis constituted almost half of patients admitted to the ICU. During the 16-year study period, there was a decline in hospital mortality over time among patients admitted with sepsis and septic shock, which occurred mainly from 2010 to 2017.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.